Design of a S-shape middle-ear ossicular replacement prosthesis and its comparison with present-day prostheses using finite element modelling.

The impedance-matching mechanism of the ossicular chain of the middle ear is disrupted by erosion of the incus, warranting prosthetic intervention. The present-day practice of straight rigid-rod is not competent to restore the required level of natural motion attenuation and force amplification between the tympanic membrane and stapes-footplate. In this work, we use finite element simulation of anatomically accurate middle ear to evaluate the efficacy. We compare the performance of differently shaped incus-prosthesis, T, C, and S in particular, using simulation. We find that the S-shaped incus-prosthesis gives the best performance. We also prototyped the prosthesis and performed a preliminary cadaveric study. The finite element simulation combined with the ability to 3D-print has the potential for effective personalized surgical intervention. [ABSTRACT FROM AUTHOR]