Department of Clinical Science, Otorhinolaryngology/Sunderby Research Unit, Umeå University, Umeå, Sweden.
Department of Physics, University of Antwerp, Antwerp, Belgium.
Otol Neurotol. 2020 Apr;41(4):537-544. doi: 10.1097/MAO.0000000000002556.
We compared the sound transmission using different types of total ossicular replacement prostheses (TORP); we then studied the performance of a new TORP that we designed inspired by the columella, the single ossicle found in birds.
Stapedial vibrations were measured on nine freshly frozen human temporal bones with laser Doppler vibrometry. We then compared the performances of eight common TORP positions or designs as well as the new silver prototype of bird-type prosthesis, designed also according to our digital holography patterns of the human tympanic membrane (TM).
The TORPs placed in lateral contact with both the TM and the malleus handle outperformed, at most frequencies, those placed only in contact with the TM.The new bird-type prosthesis performed equally well or better than all other prostheses.
If the malleus handle can be retained when placing a TORP, the best sound transmission can be achieved by placing the TORP in contact with both the distal part of the malleus handle and the TM. The good performance of our bird-type prosthesis suggests that there is still room for future improvement of prosthesis design to further optimize hearing outcomes after surgery.
我们比较了不同类型的全听骨置换假体（TORP）的传音效果；然后，我们研究了一种新的 TORP 的性能，该假体的设计灵感来自于鸟类中唯一的听小骨——听小骨柱。
使用激光多普勒测振仪测量了 9 个新鲜冷冻的人颞骨上的镫骨振动。然后，我们比较了 8 种常见的 TORP 位置或设计以及我们根据人鼓膜（TM）的数字全息图案设计的新型银质鸟型假体的性能。
与 TM 和锤骨柄均有接触的 TORP 在大多数频率下的性能优于仅与 TM 接触的 TORP。新型鸟型假体的性能与所有其他假体一样好或更好。
如果在放置 TORP 时可以保留锤骨柄，则将 TORP 放置在锤骨柄的远端和 TM 均有接触的位置可以实现最佳的传音效果。我们的鸟型假体的良好性能表明，假体设计仍有进一步改进的空间，以进一步优化手术后的听力效果。
