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Finite element analysis of repairing tympanic membrane perforation using autologous graft material and biodegradable
Liang Wang1, Hongge Han1, Jie Wang2
1Department of Mechanics and Tianjin Key Laboratory of Nonlinear Dynamics and Control, Tianjin University, Tianjin 300350, China.
Background And Objective:
As for repairing the perforated tympanic membranes (TM), temporalis fascia and tragal cartilage are popular in clinics as autologous graft materials. However, there is a significant hearing loss after repairing the TM with autologous graft materials, which needs to be addressed in biomechanical engineering.
Methods:
The finite element model of normal middle ear is improved from two aspects: the repair method of tympanic fibrous layer and the bionic spider web tympanic scaffold. By creating the solid-shell coupling condition and strong coupling boundary condition to simulate the repair, TM umbo and stapes footplate displacement-frequency response are explored in 200-8000 Hz.
Results:
The tympanic membrane perforation (TMP) causes a significant conductive hearing loss in high frequency region, which is positively correlated with perforation area. Both temporalis fascia and tragal cartilage still perform a certain degree of high-frequency hearing loss after repairing TMP. The TM attachment the magnesium alloy scaffold (MAS) prevents appropriately the high frequency hearing loss after autologous graft repair and makes the sound transmission closer to the normal condition. Significantly, the density of graft material has a negative effect on high-frequency sound transmission without the MAS. The modal-motion of TM repaired with temporalis fascia and tragal cartilage is improved significantly after attaching the MAS. In addition, the MAS restores effectively the configuration and vibration frequency of the repaired TM, which is similar to that of the native TM.
Conclusion:
The area size of TMP is studied through the finite element method, which includes autologous graft materials, the MAS, parameter sensitivity analysis, modal analysis of graft material and the MAS in biological form on the effect of middle ear sound transmission. Relevant conclusions provide some references for clinical trial protocol and the follow-up repair ideas of TM of tympanoplasty.
