Flexible Ossicular Replacement Prosthesis

An ossicular replacement prosthesis bridges a gap in the ossicular chain. It is indicated in cases of completely or partially destroyed ossicles. State of the art prostheses connect the tympanic membrane with the stapes footplate with a rigid construction. The new flexible total ossicular prostheses incorporates a microjoint mimicing the function of the joints of the intact chain.

The challenging task is to find a simple (inexpensive) design at very limited space. The new prosthesis is geared to the ostrich middle ear. Contrary to the human middle ear with three ossicles and two joints, the ostrich (like other birds) has just a columella, i.e. one ossicle with an integrated joint.  Similarly the new prosthesis got a silicone ball joint. 

The new prosthesis design can compensate for large static displacements in the reconstructed ossicular chain. It will prevent dislocations and extrusions of prostheses which are so far one major reason for failures of middle ear reconstructions.

Functionality of the new prosthesis is demonstrated in a video. It shows the function of the joint at quasi-static pressure changes, while the sound transfer through the middle ear is presented simultanly.

 Funding and development

• Funded in part by BMWi (Federal Ministry for Economic Affairs and Energy) and funding program ZIM (KF2972601KJ2)
• Development in cooperation with Kurz Medizintechnik GmbH Dusslingen, Germany

Publications

• Stoppe, Thomas, Bornitz, M., Lasurashvili, N., Sauer, K., Zahnert, T., Zaoui, K., & Beleites, T. (2018). Function, Applicability, and Properties of a Novel Flexible Total Ossicular Replacement Prosthesis With a Silicone Coated Ball and Socket Joint. Otology & Neurotology, 39(6), 739–747. https://doi.org/10.1097/MAO.0000000000001797
• Stoppe, T, Bornitz, M., Lasurashvili, N., Sauer, K., Zahnert, T., & Beleites, T. (2017). Middle ear reconstruction with a flexible prosthesis. Current Directions in Biomedical Engineering, 3(2), 143–146. https://doi.org/10.1515/cdbme-2017-0030
• Stoppe, Thomas ; Fleischer, Mario ; Bornitz, Matthias ; Zahnert, Thomas. (2014). Die Ossikelkette: Vergleich der Eigenschaften des Hammer-Amboss-Gelenks mit einer TORP-Gelenkprothese. Proceedings Der 17. Jahrestagung Der Deutschen Gesellschaft Für Audiologie. Retrieved from http://www.uzh.ch/orl/dga-ev/publikationen/tagungsbaende/tagungsbaende.html
• Sauer, K. (2016). Dynamische und statische Funktionalität einer neuartigen Mittelohrprothese mit integriertem silikongestützten Gelenk. Technische Universität Dresden, Medizinischen Fakultät Carl Gustav Carus.
• Arechvo, I., Bornitz, M., Lasurashvili, N., Zahnert, T., & Beleites, T. (2012). New total ossicular replacement prostheses with a resilient joint: Experimental data from human temporal bones. Otol Neurotol, 33(1), 60–66. https://doi.org/10.1097/MAO.0b013e31823c9352
• Arechvo, I., Zahnert, T., Bornitz, M., Neudert, M., Lasurashvili, N., Simkunaite-Rizgeliene, R., & Beleites, T. (2012). The ostrich middle ear for developing an ideal ossicular replacement prosthesis. Eur Arch Otorhinolaryngol, 270(1), 37–44. https://doi.org/10.1007/s00405-011-1907-1
• Beleites, T., Bornitz, M., Offergeld, C., Neudert, M., Hüttenbrink, K.-B., & Zahnert, T. (2007). [Experimental investigations on middle ear prostheses with an integrated micro joint]. Laryngorhinootologie, 86(9), 649–654. https://doi.org/10.1055/s-2007-966514
• Beleites, T., Bornitz, M., & Zahnert, T. (2005). Übertragungseigenschaften alternativ designter Gehörknöchelchenprothesen. Biomaterialien, 6, 12–13.