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Preliminary Model for the Design of a Custom Middle Ear Prosthesis.
Brandon Kamrava1, Jonathan A Gerstenhaber, Mamta Amin
1*Department of Otolaryngology †Department of Bioengineering, Temple University ‡Department of Anatomy and Cell Biology §Department of Neuroscience ||Department of Neurosurgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
Custom 3D-printed prostheses can recreate the incus, a small bone in the middle ear. This innovative approach offers a potential solution for improving hearing in patients with conductive hearing loss.
Area of Science:
- Biomedical Engineering
- Otolaryngology
- Medical Imaging
Background:
- Conductive hearing loss affects 55% of patients, often involving the incus due to discontinuity or fixation.
- Current reconstruction methods for the ossicular chain have yielded minimal improvements in hearing outcomes over decades.
Purpose of the Study:
- To develop a precise, patient-specific model for 3D synthesis of incudal prostheses.
- To create custom incudal replacements for improved hearing restoration in conductive hearing loss.
Main Methods:
- Detailed measurements of 19 cadaveric incudes (dimensions, weight, center of gravity) were collected.
- Micro-computed tomography (micro-CT) of temporal bones provided anatomical data for a rasterizable incus model.
- 3D-printed incudal replacements were created and tested in a cadaveric temporal bone model.
Main Results:
- Cadaveric incus measurements closely matched existing medical literature data.
- Micro-CT identified critical, consistent incus features, informing model modifications for stability.
- 3D-printed incudal replacements accurately fitted cadaveric temporal bones, bridging the malleus-incus gap.
Conclusions:
- A validated model for custom 3D-synthesized incudal prostheses has been established.
- While biocompatible material limitations exist, rapid advancements in 3D printing technology support the feasibility of producing accurate incudal replacements.
