Abstract
In the case of otosclerosis, it has been noticed that even though there are a variety of different prostheses on the market, due to the anatomical characteristics, it is not always possible to restore excellent mobility to the ossicles and the prosthesis. On the one hand, this happens because the incus long process and the prosthesis create difficult angles. On the other hand, incus necrosis is among the most common causes of the loss of stability to the prosthesis and stapedectomy failure. The aim of this research is to suggest an improvement for stapes prosthesis stability and numerically evaluate the impact of the prosthesis constraining to its dynamical behavior. Numerical 3D models of a standard as well as a modified (adjustable angled) stapes prosthesis were created in order to achieve this aim. Consequently, the modal analysis has been performed to evaluate the mechanical behavior of the prosthesis, assuming that the piston (thick part) would be made of Teflon, and the thin part, fixated on the incus long process, would be made from titanium alloy. Finally, the numerical analysis has been conducted by changing the boundary conditions in respect of the prosthesis constraining, where the attached stapes prosthesis connects to the ossicular chain. Subsequently, there were two hypotheses raised for the prosthesis loop constraining. The first is that during the surgery, the prosthesis is perfectly crimped with certain looseness. The second is that the prosthesis is outgrown by the tissues over time and thus becomes over-constrained. Then, the analyzed standard stapes prosthesis does not fulfil its functions because of the over-constraining that develops over time. An improvement for the standard stapes prosthesis, i.e., a modified stapes prosthesis (adjustable angled), that has been proposed in this research allows avoidance of the negative effects of the over-constrained standard stapes prosthesis that appear over time. Moreover, the proposed modified prosthesis helps to regain hearing when the angle between the incus long process and prosthesis is unfavorable.
Highlights
The human hearing capability is assured due to the conduction of mechanical vibrations along the ossicular chain to the inner ear [1]
The fixation of the stapes prosthesis loop on the incus long process is influenced by the crimping of the loop [12,13]
The presented research work revealed a study of theadynamic behavior ofbehavior a modified adjustable stapes prosthesis, which may allow avoidance of anatomical disturbances and adjustable stapes prosthesis, which may allow avoidance of anatomical disturbances and instability of the prosthesis in the long-term due to the necrosis/hyperostosis
Summary
The human hearing capability is assured due to the conduction of mechanical vibrations along the ossicular chain to the inner ear [1]. The ossicular chain consists of three bones: the malleus, the incus, and the stapes (see Figure 1 [2]) that connects the tympanic membrane to the inner ear and plays an important role in amplifying and regulating sound waves [3]. The ossicular chain movements represent a key role in the process of hearing. The incus, the middle bone in the ossicular chain, is often reported in existing studies to be the most eroded bone and more distant from the cholesteatoma entrance [4,5]. Otosclerosis is a bone remodeling disorder in which the footplate of the stapes is replaced by an abnormal
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