Search Results (6)

Ossiculoplasty (OPL) aims to restore ossicular chain continuity to improve hearing in patients with conductive or mixed hearing loss, often performed during tympanoplasty. The current training methods, including cadaveric temporal bone models, face challenges such as limited availability, high costs, and biological risks, prompting the exploration of alternative models. This study introduces a novel training platform for OPL using 3D-printed temporal bones and incudes, including a magnified (3:1) model to enhance skill acquisition. Sixty medical students were divided into two groups: one trained on magnified models before transitioning to real-sized ones, and the other used only real-sized models. Training performance was quantitatively assessed using post-remodeling cone-beam CT imaging and mesh distance analysis. The results showed a significant improvement in performance for students with preliminary training on magnified models (87% acceptable results vs. 37%, p = 0.001). Qualitative feedback indicated higher confidence and skill ratings in the magnified model group. This study highlights the effectiveness of scalable, anatomically accurate synthetic models for complex surgical training. While further validation is required with experienced trainees and broader scenarios, the findings support the integration of 3D printing technologies into otologic education, offering a cost-effective, reproducible, and innovative approach to enhancing surgical preparedness. Full article

Ossiculoplasty is a surgical operation performed to restore auditory transmission through the reconstruction of the ossicular chain using prosthetics. Tissue bioengineering has assumed a pivotal role in implementing alternatives to conventional ossicular middle ear replacement prostheses, to overcome extrusion while preserving acoustic properties. This in vitro study aims to explore, for the first time in current literature, the feasibility of a biohybrid middle ear prosthesis, composed of titanium surrounded by a bone extracellular matrix as bio-coating. We have hereby studied the adhesion and proliferation of human adipose-derived mesenchymal stem cells (hASC) on titanium scaffolds in vitro. Moreover, we identified the osteogenic differentiation of hASC using an immunofluorescence assay to analyze osteoblasts’ gene expression profiles (Alp, Runx2, Col1a1, Osx, and Bglap), and we counted the presence of collagen as a marker of hASC’s ability to secrete an extracellular matrix. We utilized scanning electron microscopy to evaluate the presence of an extracellular matrix on the scaffolds. Our preliminary data demonstrated the titanium’s ability to support human adipose-derived mesenchymal stem cell colonization, proliferation, and osteoblastic differentiation, in order to obtain a biohybrid device. Our experience seems encouraging; thus, we advocate for further in vivo research to corroborate our results regarding bone transplantation. Full article

Background: The persistent stapedial artery (PSA) is a rare congenital vascular malformation involving the middle ear. It is usually associated with pulsatile tinnitus and/or conductive hearing loss and can account for multiple risks during middle ear surgery. Case Report: we present a case of a 9-year-old male child with conductive hearing loss and persistent stapedial artery in his right ear, who was admitted to our ENT Department for hearing loss. During surgery, we discovered PSA along with congenital stapes agenesis and oval window atresia, as well as an abnormal trajectory of the mastoid segment of the facial nerve. After ossicular reconstruction (transcanal total ossicular replacement prosthesis) with cochleostomy, no surgical complications were recorded and hearing improvement was monitored by pre- and postoperative audiometry. Conclusion: Stapedial artery is a rare anatomical middle ear abnormality that can prevent proper surgical hearing restoration and can be associated with other simultaneous temporal bone malformations. Full article

Background and objectives: We review the intraoperative findings and postoperative outcomes of ossiculoplasty in subjects with second pharyngeal arch (SPA)-derived ossicular anomalies. We summarize potential intraoperative complications and recommend precautions that may reduce the risk of fracture. Materials and Methods: Twenty-four patients with SPA-derived ossicular anomalies were included, and pre- and postoperative audiometric results were compared. Results: The mean air conduction threshold (56.0 ± 12.4 dB HL) was significantly improved 1 month (27.6 ± 10.1 dB HL) and 6 months (23.8 ± 13.2 dB HL) after surgery (p < 0.001). The preoperative air–bone gap (ABG) (40.4 ± 7.4 dB HL) was significantly decreased at 1 month (15.1 ± 5.9 dB HL) and 6 months (11.3 ± 8.9 dB HL) postoperation. ABG closure was successful (<20 dB HL) in 21 (87.5%) patients 6 months after surgery. Intraoperative footplate fractures occurred in 3 of 24 patients. The fractures were managed successfully, and the ABG closure was successful in all cases. Conclusions: The stapes footplate is likely to be relatively thin in subjects with SPA-derived ossicular anomalies because the footplate is partially or totally derived from the SPA. Thus, a fragile footplate should be expected, and care is needed when handling the footplate. However, when complications are overcome, the audiological outcomes are excellent in most cases. Full article

Polymers modified with bioactive nanoparticles are a promising solution for patients who need a tissue replacement. Modern implants, thanks to bioactive and bactericidal functions, facilitate the healing and regeneration process of the replaced tissue. The aim of this study was to assess whether silver nanoparticles (AgNPs) could support antibacterial function without cytotoxic effect and deterioration of biostability. This article describes biological and physiochemical aspects concerning a new polymeric middle ear implant (Otoimplant) enriched with silver nanoparticles. This kind of prosthesis is a promising implant for the reconstruction of ossicles in ossiculoplasty. We found that incorporation of silver nanoparticles into a polymeric matrix resulted in bactericidal efficacy against Gram-positive and Gram-negative bacteria, both resistant to antibiotics and basic strains. Our prostheses do not show cytotoxic effect and are a suitable biomaterial platform for effective culture of Saos2 and NHOst osteoblastic cells. The in vitro incubation of the samples in distilled water revealed that surface parameters, such as roughness, may slightly increase as a result of unveiling nanoparticles. However, the prolonged immersion does not change mechanical parameters. During one-year incubation, the prosthesis proved to retain stable values of Young’s modulus, tensile strength, propagation of longitudinal ultrasonic waves, pH, and conductivity. Full article

Aural atresia and severe microtia are associated malformations that result in problems with hearing and cosmesis, associated speech and language difficulties and diminished self-esteem. In cases where middle ear ossiculoplasty and aural atresia canalplasty are expected to give poor hearing outcomes that would eventually require the use of hearing aids, bone anchored hearing aids or active middle ear implants may be better options. This case report describes a simultaneous Vibrant Soundbridge implantation and 2^nd stage auricular reconstruction with rib graft cartilage for an 11-year-old boy with grade III microtia and aural atresia 8 months after the 1^st stage reconstruction. Audiometric results of the Vibrant Soundbridge aided ear were comparable to that of the contralateral hearing aid aided ear. Full article