The impact of fixated glass ionomer cement and springy cortical bone incudostapedial joint reconstruction on hearing results.
ABSTRACT Although it abolishes the incudostapedial joint, use of glass ionomer cement to repair the defect between the stapes head and the long process of the incus is a successful procedure when the hearing results are considered.
To compare the hearing results obtained by a fixed, stiff reconstruction with glass ionomer cement, and a flexible, springy pseudo-joint built with autologous cortical bone in patients with a small defect between the long process of the incus and the stapes head.
A total of 66 patients who had canal wall up tympanomastoidectomy due to chronic otitis media and incus long process defect between January 1996 and February 2008 were analyzed retrospectively. Their incudostapedial joints were reconstructed using either glass ionomer cement (n=31) or autologous cortical bone (n=35).
The mean follow-up period was 22.8 months for all cases. The mean postoperative air bone gap (ABG) was 29.2 dB and it reduced to 11.8 dB at the end of the follow-up period. Preoperative and postoperative ABGs were 27.4 dB and 10.6 dB in the glass ionomer cement group and 30.9 dB and 12.8 dB in the cortical bone group, respectively. The ABG closure was 16.8 dB in the glass ionomer cement group and 18 dB in the cortical bone group.
Article: Experimental measurement and modeling analysis on mechanical properties of incudostapedial joint.[show abstract] [hide abstract]
ABSTRACT: The incudostapedial (IS) joint between the incus and stapes is a synovial joint consisting of joint capsule, cartilage, and synovial fluid. The mechanical properties of the IS joint directly affect the middle ear transfer function for sound transmission. However, due to the complexity and small size of the joint, the mechanical properties of the IS joint have not been reported in the literature. In this paper, we report our current study on mechanical properties of human IS joint using both experimental measurement and finite element (FE) modeling analysis. Eight IS joint samples with the incus and stapes attached were harvested from human cadaver temporal bones. Tension, compression, stress relaxation and failure tests were performed on those samples in a micro-material testing system. An analytical approach with the hyperelastic Ogden model and a 3D FE model of the IS joint including the cartilage, joint capsule, and synovial fluid were employed to derive mechanical parameters of the IS joint. The comparison of measurements and modeling results reveals the relationship between the mechanical properties and structure of the IS joint.Biomechanics and Modeling in Mechanobiology 11/2010; 10(5):713-26. · 3.19 Impact Factor