Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland.
Katedra i Klinika Otorynolaryngologii Chirurgii Głowy i Szyi, Warszawski Uniwersytet Medyczny.
Otolaryngol Pol. 2023 Feb 20;77(2):1-5. doi: 10.5604/01.3001.0016.2703.
In tympanoplasty, surgical reconstruction of the tympanic membrane and ossicular chain is well-established; however, its hearing results still require improvement. Custom 3D printing of individualized ossicular prostheses seems to be an attractive solution for optimal prosthesis adjustment and better hearing results.
The aim was to design a custom ossicular prosthesis using a 3D printing method based on Cone-beam Computed Tomography (CBCT) scans and assess the acoustic conduction properties of such prosthesis.
A cadaver fresh frozen temporal bone was used. Based on CBCT images, a new incus prosthesis was designed and 3D printed. Next, canal wall-up tympanoplasty was performed. The intact ossicular chain and reconstructed 3D-printed prosthesis chain movements/vibrations were measured with Laser Doppler Vibrometer (LDV) system and analyzed in detail.
The CBCT scans provided enough information about the anatomical structures. For frequencies 500 and 1000 Hz and 80 dB SPL sound intensity, collected velocities were higher for the intact ossicular chain than the 3D-printed ossicular prosthesis. The intensity thresholds for movement at 500 and 1000 Hz were lower in the intact ossicular chain than in the 3D-printed ossicular prosthesis. At 2000 Hz, there was the same intensity threshold value in the two measured circumstances.
It is possible to design a custom individually fitted ossicular prosthesis using a 3D printing method based on CBCT scans. The acoustic conduction properties of such 3D-printed prosthesis showed differences in movability pattern between the intact and reconstructed ossicular chain. More data are needed to analyze the acoustic properties of such designed prostheses in detail. The results of our experiment showed the 3D-printed prosthesis presents the potential to be an interesting option for conductive hearing loss treatment caused by chronic otitis media and the ossicular chain defects.
在鼓膜成形术中，对鼓膜和听骨链的手术重建已得到充分确立；然而，其听力结果仍需改善。定制 3D 打印个体化听小骨假体似乎是一种有吸引力的解决方案，可以实现最佳假体调整和更好的听力结果。
旨在使用基于锥形束 CT（CBCT）扫描的 3D 打印方法设计定制的听小骨假体，并评估该假体的声学传导特性。
使用新鲜冷冻的颞骨尸体。基于 CBCT 图像，设计并 3D 打印出新的砧骨假体。接下来，进行鼓室成形术。使用激光多普勒测振仪（LDV）系统测量完整听小骨链和重建的 3D 打印假体链的运动/振动，并进行详细分析。
CBCT 扫描提供了足够的解剖结构信息。对于 500Hz 和 1000Hz 及 80dB SPL 声强，收集到的速度在完整听小骨链中高于 3D 打印听小骨假体。在 500Hz 和 1000Hz 时，运动的强度阈值在完整听小骨链中低于 3D 打印听小骨假体。在 2000Hz 时，两种测量情况下的强度阈值相同。
使用基于 CBCT 扫描的 3D 打印方法设计定制的个体化听小骨假体是可行的。这种 3D 打印假体的声学传导特性显示，在可动性模式方面，完整和重建的听小骨链之间存在差异。需要更多的数据来详细分析这种设计假体的声学特性。我们的实验结果表明，这种 3D 打印假体有可能成为慢性中耳炎和听小骨链缺损引起的传导性听力损失治疗的一个有趣选择。
