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of a stapes prosthesis onto the incus.

Incus Stapes Superstructure Replacement Prosthesis - …

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I-SRP - Incus Stapes Superstructure Replacement Prosthesis

Definition : Implantable ossicular prostheses designed to replace one or both of the middle and innermost middle ear ossicles (i.e., incus and stapes, respectively). These prostheses are typically made of bioactive materials such as hydroxyapatite, bioactive glasses, silastic, stainless steel, titanium, or high-density polyethylene sponge (HDPS); some materials require placement of cartilage between the prosthesis and the tympanic membrane to prevent extrusion. Sculpted autografts and allografts are less frequently used as ossicular prostheses. Incus and/or stapes prostheses are used mainly to reestablish the middle ear sound-conducting mechanism; they are also used to repair congenital abnormalities in the ossicles, improving a patient's hearing capabilities.

It is Incus Stapes Superstructure Replacement Prosthesis

Entry Terms : "Prostheses, Ossicular, Incus/Stapes" , "Prostheses, Stapedial" , "Prostheses, Middle Ear Ossicle, Incus" , "Prostheses, Middle Ear Ossicle, Stapes" , "Stapes Middle Ear Prostheses" , "Incus Middle Ear Prostheses" , "Stapes Prostheses"

Wehrs HAPEX incus-stapes prosthesis.

Prostheses, Middle Ear Ossicle, Incus/Stapes

The upper portion of the stapes bone is then vaporized with a Laser). The distance between the fixed stapes footplate and the mobile incus (2nd bone of hearing) is measured to select the properly sized prosthesis. A 0.7mm hole in the fixed stapes footplate is created with the Laser. The prosthesis is then inserted into the footplate hole and then “welded” to the incus with the Laser. A small piece of tissue from the back of the ear lobule is draped around the prosthesis at the footplate hole to seal it.

Success rates of stapedotomy are traditionally assessed by the closure of the air-bone gap on audiometry with a good outcome generally accepted to be within 10 dB or less, closure of the preoperative air-bone gap. Success rates of surgery vary from 17% to 80% []. The common causes of failure of stapedotomy include prosthesis displacement, incus necrosis, undiscovered fixation of the incus or malleus, adhesions in the middle ear, and oval window fibrosis. Revision stapedotomy procedures are associated with inferior hearing outcomes and greater comorbidity [, ].

the stapes prosthesis can be attached to the incus (incus ..

Disclosed is a prosthetic device for replacing a portion of the incus when the stapes or a portion of the lenticular process is generally intact

The SMart prosthesis is one of the newer stapes prostheses available on the market, and a number of large series have shown good surgical outcomes with its usage [, ]. The piston exhibits shape memory whereby the application of heat leads to a phase alteration in the atomic structure resulting in the formation of a predetermined shape. In the case of a SMart prosthesis, this results in the crimping of the hook around the incus. As this crimping occurs, increased contact with the incus generates stress which acts to inhibit the memory properties and therefore stop the crimping process []. This should produce a snugly fitted secure prosthesis.

The Megerian Stapes Replacement Prothesis is a heat activated, nitinol stapes replacement prosthesis. The piston features 6 tapered nitinol arms that follow the natural contour of the incus. With this unique design, the surgeon can adapt the SRP for use with a necrosed incus. The Megerian SRP ranges in lengths from 4.00mm to 5.00mm in quarter millimeter increments.

..reasons for unexpected failures of stapes surgery may be the insufficient crimping of a stapes prosthesis onto the incus.
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For this reason, some surgeons prefer a bucket handle prosthesis

The Bartels Bucket Handle prosthesis was specially designed with an adjustable diameter bucket to accommodate a small, medium or large sized incus. This feature greatly reduces hospital inventories. An additional feature is the stepped down shaft of the prosthesis. The Bartels is offered in 0.4mm, 0.5mm or 0.6mm diameter, with the shaft of each stepped down to 0.3mm. The stepped down shaft provides better clearance with an over-hanging facial nerve or promontory. The Bartels has a 1mm polished depth gauge to aid in determining depth into the vestibule.

Stapes Prostheses - Products - Grace Medical

In our case, the prosthesis was successfully crimped at time of initial surgery with good audiological evidence of improvement. The prosthesis, however, was found to be “uncrimped” during surgery. We would not classify this as a prosthesis displacement, the commonest cause of late failure of surgery, as the piston was still in contact with the incus and the stapes footplate. The uncrimping of the prosthesis has led to poor sound transmission and hence deterioration of hearing thresholds.

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