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Numerical study of Hough technique in surgery of otosclerosis, using the finite element method

Gentil F., Parente M., Martins P., Santos C., Almeida E., Ferreira A., Natali R.

Acta of Bioengineering and Biomechanics

2015

Vol. 17, no. 4

149--153

Purpose: Otosclerosis is a metabolic bone disease of the otic capsule that can cause the stapes fixation, resulting in conductive hearing loss or, in a profound sensorineural deafness threshold. Surgery is one of the possible treatments for the otosclerosis. To repair small focus of otosclerosis in the anterior crus of the stapes, in 1960, Hough suggested the implementation of a technique in which part of the anterior crus is fractured and the stapes turned. As a result, the posterior crus of the stapes is the only connection with the inner ear. In this work, the outcome of Hough’s surgical technique was simulated. Methods: Based on computerized images, a finite element model of middle ear ossicles and tympanic membrane was created, as well as a model where the stapes has changed. The discretization of the tridimensional solid model was made using the ABAQUS software. The mechanical properties used were taken from the literature and adequate boundary conditions were applied. Results: The results obtained with the Hough technique simulation were compared with a representative model of the normal ear, taking into account the displacements obtained on the central part of the stapes footplate and the maximum principal stress in the stapes crus. Conclusions: The results obtained are closer to the normal ear model, therefore Hough technique stands out as a good option to correct small focus of otosclerosis.

Differences in the perilymph fluid stimulation before and after experimental stapedotomy

Kwacz M., Mrówka M., Wysocki J.

Acta of Bioengineering and Biomechanics

2012

Vol. 14, no. 2

67-73

A stapedotomy surgery using a piston stapes prosthesis significantly modifies the perilymph fluid stimulation level and always leads to alteration of conditions in sound transmission through the cochlea. This paper shows the results of non-contact measurements of the stapes head velocity, a Teflon piston stapes prosthesis velocity and round window velocity conducted in freshly harvested human cadaver temporal bone specimens. The vibration patterns were measured within the frequency range of 0.4-10 kHz at the sound pressure level of 90 dB administered to the external auditory canal in the same specimen before and after experimental stapedotomy. It was shown that the vibrations of the stapes Teflon piston prosthesis and the physiological stapes are similar and approximately five-fold lower amplitude of the round window membrane vibrations compared to a physiologic situation is caused by piston shape of the stapes prosthesis. The results in this report are the part of a larger study designed to develop a new type of chamber stapes or whole middle ear prosthesis.

Round window membrane motion before and after stapedotomy surgery - an experimental study

Kwacz M., Mrowka M., Wysocki J.

Acta of Bioengineering and Biomechanics

2011

Vol. 13, no. 3

27-33

This paper presents the results of non-contact measurements of the human ear round window (RW) membrane motion in freshly harvested human cadaver temporal bone specimens. A PSV 400 Scanning Laser Vibrometer system (Polytec, Waldbronn, Germany) was used to determine the effect of stapedotomy on the sound-induced displacement amplitude of the RW membrane. The vibration patterns were measured in the frequency range of 0.4–10 kHz in four specimens with air conduction stimulation at 90 dB SPL applied to the external auditory canal. It was shown that the vibration amplitude of the RW membrane after stapes piston prosthesis implantation, in comparison with a physiological specimen, was reduced several times. The motion of the RW membrane can be used to determine the cochlear stimulation for the evaluation of middle ear ossicle reconstruction, especially in the case of otosclerosis surgery.