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Quantitative analysis of 3D-printed custom ossicular prostheses motion using laser Doppler vibrometry

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Sokołowski J., Orłowski A., Bartoszewicz R., Lachowska M., Gosiewska A., Biecek P., Niemczyk K.
Polish Journal of Otolaryngology
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2023
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vol. 77
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issue 6
23-30
EN
Introduction: In chronic otitis media, the reconstruction of the middle ear's sound conducting system involves repairing the tympanic membrane and filling the space between ossicular chain remnants. The final shape of the prosthesis is usually determined intraoperatively. However, the ossicular chain may be preoperatively measured using computed tomography (CT) scans, and an individualized prosthesis can be designed. Custom 3D printing seems to be an attractive solution for optimal adjustment. Aim: Our study aimed to assess the 3D-printed custom prosthesis movability and compare it to the original ossicular chain. Material and methods: Five fresh-frozen temporal bone specimens were used. Using Cone-Beam CT scans, the incus model was designed individually and 3D-printed. The ossicular chain was reconstructed inside the cadaveric temporal bone. Acoustic stimuli were applied to the external ear canal one frequency at a time. The laser Doppler vibrometer (LDV) measured the intact and 3D-printed prosthesis reconstructed ossicular chain vibrations. Results: At all stimulation frequencies, there was no significant difference in velocity values between the intact and reconstructed ossicular chain at the intensity of 80 dB SPL. The obtained values of the velocity gain were: −7.9 (SD-19) dB, −6.8 (SD8.12) dB, −10,9 (SD-5.3) dB, −7.4 (SD-8.16) dB for 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, respectively. The vibration threshold shift values ranged between –0.57 dB at 500 Hz and 3.81 dB at 2000 Hz. Conclusions: This study analyzed the movability of individualized 3D-printed custom ossicular prostheses using LDV. Compared to the intact ossicular chain, the reconstructed ossicular chain movability was characterized by statistically insignificant reduced movability at all tested frequencies. Because the prosthesis's new design conception as custom 3D individualized printing allows for patient-specific ossiculoplasty, it represents a promising new direction for ossicular chain reconstruction. It seems to be an attractive solution for prosthesis optimal adjustment and, hopefully, better hearing results.
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3D-printed custom ossicular prosthesis – methodology of design and LDV measurements in a cadaver study

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Sokołowski J., Orłowski A., Lachowska M., Gosiewska A., Biecek P., Bartoszewicz R., Niemczyk K.
Polish Journal of Otolaryngology
|
2023
|
vol. 77
|
issue 3
12-19
EN
Introduction: 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. Aim: 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. Material and methods: 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. Results: 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. Conclusion: 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.
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