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Stapes footplate

Thomas Zahnert, Marie-Luise Metasch, Hannes Seidler, Matthias Bornitz, Nicoloz Lasurashvili, Marcus Neudert
HYPOTHESIS: Electromagnetical excitation of ossicular vibration is suitable for middle ear transmission measurements in the experimental and clinical setting. Thereby, it can be used as a real-time monitoring system for quality control in ossiculoplasty. BACKGROUND: Positioning and coupling of middle ear prosthesis are a precondition for good postoperative hearing results, but at the same time completely dependent upon the surgeon's subjective judgment during surgery...
October 4, 2016: Otology & Neurotology
Vânia Henriques, Rafaela Teles, Ana Sousa, Roberto Estevão, Jorge Rodrigues, Alexandra Gomes, Francisco Silva, Ângelo Fernandes, Fausto Fernandes
Congenital middle ear malformations are rare. Most part of them are usually associated with other malformations, such as aural atresia, microtia, and dysmorphic craniofacial features. A clinical case of a 24-year-old male with a right-sided conductive hearing loss since his childhood, without craniofacial malformation, is presented. He was proposed for exploratory tympanotomy under the suspicious diagnosis of otosclerosis. The surgery revealed an abnormal location of stapes' superstructure, which was attached to the promontory and had an isolated and mobile osseous footplate in the oval window...
2016: Case Reports in Otolaryngology
Inge Wegner, Mostafa M A S Eldaebes, Thomas G Landry, Wilko Grolman, Manohar L Bance
HYPOTHESIS: The use of larger-diameter pistons in stapedotomy leads to better hearing outcomes compared with the use of smaller-diameter pistons. There is an interaction between stapes piston diameter and fenestration diameter. BACKGROUND: Otosclerosis can be treated surgically by removing part of the stapes and bypassing the stapes footplate with a prosthesis. Available piston shaft diameters range between 0.3 and 0.8 mm. There has been a tendency toward the use of smaller-diameter pistons, because of a suspected decreased risk of cochlear trauma and subsequent sensorineural hearing loss (SNHL) with smaller pistons...
September 16, 2016: Otology & Neurotology
Marcus Neudert, Matthias Bornitz, Nikoloz Lasurashvili, Uwe Schmidt, Thomas Beleites, Thomas Zahnert
HYPOTHESIS: Prosthesis' length creates tension in ossicular reconstructions, which directly effects the middle ear sound transmission. BACKGROUND: Relatively long prostheses are often used to stabilize the middle ear reconstruction to prevent dislocation. Thereby, tension on the flexible components such as the tympanic membrane (TM) and the annular ligament (AL) is increased. Only little is known on the amount of displacement-related stiffening of the TM and AL, as well as the consecutive reduction in middle ear transfer function (METF)...
October 2016: Otology & Neurotology
Bruno Areias, Carla Santos, Renato M Natal Jorge, Fernanda Gentil, Marco Pl Parente
The ear is one of the most complex organs in the human body. Sound is a sequence of pressure waves, which propagates through a compressible media such as air. The pinna concentrates the sound waves into the external auditory meatus. In this canal, the sound is conducted to the tympanic membrane. The tympanic membrane transforms the pressure variations into mechanical displacements, which are then transmitted to the ossicles. The vibration of the stapes footplate creates pressure waves in the fluid inside the cochlea; these pressure waves stimulate the hair cells, generating electrical signals which are sent to the brain through the cochlear nerve, where they are decoded...
September 2, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Antoniu-Oreste Gostian, Jean-Marc Kouamé, Martin Bremke, Magdalene Ortmann, Karl-Bernd Hüttenbrink, Dirk Beutner
Importance: Multiple techniques for a more secure and stable anchoring of the foot of a total ossicular replacement prosthesis (TORP) on the footplate have been proposed. To address this issue, a technique was developed that fits a cartilage shoe into the oval niche to guide the base of the prosthesis into a preformed central perforation. Objective: To evaluate the long-term results of the cartilage shoe technique used to anchor a titanium TORP on the stapes footplate in patients after type III tympanoplasty...
August 18, 2016: JAMA Otolaryngology—Head & Neck Surgery
Maimi Ozeki-Satoh, Aoi Ishikawa, Shigehito Yamada, Chigako Uwabe, Tetsuya Takakuwa
We describe the three-dimensional morphogenesis of the middle ear ossicles (MEOs) according to Carnegie stage (CS) in human embryos. Seventeen samples including 33 MEOs from CS18 to 23 were selected from the Kyoto Collection. The primordia of the MEOs and related structures were histologically observed and three-dimensionally reconstructed from digital images. The timing of chondrogenesis was variable among structures. The stapes was recognizable as a vague condensation of the mesenchymal cells in all samples from CS18, whereas the malleus and incus were recognizable at CS19...
October 2016: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
Nicolas Verhaert, Joris Walraevens, Christian Desloovere, Jan Wouters, Jean-Marc Gérard
Severe to profound mixed hearing loss is associated with hearing rehabilitation difficulties. Recently, promising results for speech understanding were obtained with a direct acoustic cochlear implant (DACI). The surgical implantation of a DACI with standard coupling through a stapedotomy can however be regarded as challenging. Therefore, in this experimental study, the feasibility of direct acoustic stimulation was investigated at an anatomically and surgically more accessible inner ear site. DACI stimulation of the intact, blue-lined and opened lateral semicircular canal (LC) was investigated and compared with standard oval window (OW) coupling...
2016: PloS One
Swati Tandon, Satinder Singh, Shalabh Sharma, Asish K Lahiri
INTRODUCTION: Congenital anomalies of the cochlea and labyrinth can be associated with meningitis and varying degrees of hearing loss or deafness. Despite antibiotics, meningitis remains a life threatening complication. CASE REPORT: We report a case of recurrent meningitis following episodes of otitis media in a cochlear implantee child with bilateral vestibulocochlear malformation, due to fistula in the stapes footplate. Intrathecal fluorescin was used to identify the leak site...
May 2016: Iranian Journal of Otorhinolaryngology
Xinping Hao, Shubin Chen, Zilong Yu, Fenghe Liang, Yongxin Li
OBJECTIVE: To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. METHOD: Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle...
March 2016: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Richard P Tucker, Cathryn A Peterson, Ismail Hendaoui, Sandrine Bichet, Ruth Chiquet-Ehrismann
The ossicles of the middle ear (the malleus, incus and stapes) transmit forces resulting from vibrations of the tympanic membrane to the cochlea where they are coded as sound. Hearing loss can result from diseases such as rheumatoid arthritis (RA) that affect the joints between the ossicles or degenerative processes like otosclerosis that lead to ankylosis of the footplate of the stapes in the oval window of the cochlea. In this study, immunohistochemistry was used to determine if the extracellular matrix glycoproteins tenascin-C or tenascin-W are expressed in the incudomalleolar and incudostapedial joints of ossicles dissected from human cadavers...
September 2016: Journal of Anatomy
Jin Meng, Shundong Bi, Xiaoting Zheng, Xiaoli Wang
The middle ear bones of Mesozoic mammals are rarely preserved as fossils and the morphology of these ossicles in the earliest mammals remains poorly known. Here, we report the stapes and incus of the euharamiyidan Arboroharamiya from the lower Upper Jurassic (∼160 Ma) of northern China, which represent the earliest known mammalian middle ear ossicles. Both bones are miniscule in relation to those in non-mammalian cynodonts. The skull length/stapedial footplate diameter ratio is estimated as 51.74 and the stapes length as the percentage of the skull length is 4%; both numbers fall into the stapes size ranges of mammals...
May 26, 2016: Journal of Morphology
Jan Christoffer Lüers, David Schwarz, Andreas Anagiotos, Antoniu-Oreste Gostian, Dirk Beutner, Karl Bernd Hüttenbrink
OBJECTIVE: Analysis of the audiometric results after repair of a defective footplate with the sandwich cartilage shoe technique in a follow-up study. STUDY DESIGN: Retrospective analysis of audiometric data. SETTING: Hospital. PATIENTS: The cohort consisted of 12 patients, who underwent ossicular reconstruction after sandwich cartilage shoe technique in a case of insecure stapes footplate. The mean age was 42.7 years with an equal sex distribution...
August 2016: Otology & Neurotology
Antoniu Oreste Gostian, David Pazen, Magdalene Ortmann, Andreas Anagiotos, David Schwarz, Karl Bernd Hüttenbrink, Dirk Beutner
HYPOTHESIS: High loads forcing the floating mass transducer (FMT) of a single active middle ear implant toward the round window membrane (RWM) affect the backward stimulation of the cochlea. BACKGROUND: Various factors influence the backward stimulation of the cochlea. We investigated the effects of various loads applied to the FMT together with different coupling techniques at the fully exposed RWM on the vibration transmission. METHODS: Experimental study on temporal bones with the FMT linked to a load cell mounted on a translation stage moving it against the fully exposed RWM with increasing loads up to 200 mN by itself, with interposed perichondrium, cartilage or connected to the round window coupler...
June 2016: Otology & Neurotology
Maurizio Barbara, Luigi Volpini, Edoardo Covelli, Chiara Filippi, Simonetta Monini
OBJECTIVE: To verify the efficacy of a powerful active hearing device in a patient different from far-advanced otosclerosis, specifically when the stapes footplate is mobile. PATIENT: A patient with severe-to-profound mixed hearing loss, who was not benefiting from the use of a conventional hearing aid, was selected for an inner ear active implant. This was justified by a bone conductive threshold above 60 dB, which had discouraged any other rehabilitative solutions such as a bone conductive implant, or an active middle ear implant (AMEI)...
June 2016: Otology & Neurotology
Joanna L Ziff, Michael Crompton, Harry R F Powell, Jeremy A Lavy, Christopher P Aldren, Karen P Steel, Shakeel R Saeed, Sally J Dawson
Otosclerosis is a relatively common heterogenous condition, characterized by abnormal bone remodelling in the otic capsule leading to fixation of the stapedial footplate and an associated conductive hearing loss. Although familial linkage and candidate gene association studies have been performed in recent years, little progress has been made in identifying disease-causing genes. Here, we used whole-exome sequencing in four families exhibiting dominantly inherited otosclerosis to identify 23 candidate variants (reduced to 9 after segregation analysis) for further investigation in a secondary cohort of 84 familial cases...
April 7, 2016: Human Molecular Genetics
Inge Wegner, Mostafa M A S Eldaebes, Thomas G Landry, Robert B Adamson, Wilko Grolman, Manohar L Bance
HYPOTHESIS: Round window reinforcement leads to conductive hearing loss. BACKGROUND: The round window is stiffened surgically as therapy for various conditions, including perilymphatic fistula and superior semicircular canal dehiscence. Round window reinforcement reduces symptoms in these patients. However, it also reduces fluid displacement in the cochlea and might therefore increase conductive hearing loss. METHODS: Perichondrium was applied to the round window membrane in nine fresh-frozen, nonpathologic temporal bones...
June 2016: Otology & Neurotology
Martin Koch, Till Moritz Eßinger, Thomas Stoppe, Nikoloz Lasurashvili, Matthias Bornitz, Thomas Zahnert
A fully implantable hearing aid is introduced which is a combined sensor-actuator-transducer designed for insertion into the incudostapedial joint gap (ISJ). The active elements each consist of a thin titanium membrane with an applied piezoelectric single crystal. The effectiveness of the operating principle is verified in a temporal bone study. We also take a closer look at the influence of an implantation-induced increase in middle ear stiffness on the transducer's output. An assembly of the transducer with 1 mm thickness is built and inserted into six temporal bones...
March 31, 2016: Hearing Research
Sebastian P Schraven, Robert Mlynski, Ernst Dalhoff, Andreas Heyd, Daniela Wildenstein, Kristen Rak, Andreas Radeloff, Rudolf Hagen, Anthony W Gummer
The active middle-ear implant Vibrant Soundbridge(©) (VSB) is used to treat mild-to-severe sensorineural hearing losses. The standard surgical approach for incus vibroplasty is a mastoidectomy and a posterior tympanotomy, crimping the Floating Mass Transducer (FMT) to the long process of the incus (LPI) (standard crimped application). However, tight crimping increases the risk of necrosis of the LPI, resulting in reduction of energy transfer and loss of amplification. The aim of this study was to develop a new coupling device for the LPI, that does not require crimping, and to test its vibrational transfer properties in temporal-bone preparations...
March 29, 2016: Hearing Research
John Peacock, Joris Dirckx, Magnus von Unge
Determining the degree of ossicular fixation is a difficult task, with the final assessment often being made with manual palpation during exploratory tympanotomy. A more objective method to evaluate ossicular fixation would be valuable. In this paper we describe a new method which makes use of a magnet and coil to measure ossicular motion through the ear canal with an elevated tympanic membrane. We report measurements of the vibration response at the umbo, the tip of the incus long process and the lateral posterior crus of the stapes before and after artificially fixing the stapes footplate and anterior mallear ligament with luting cement...
March 28, 2016: Hearing Research
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