Abstract
Purpose
The aims of the present study were to identify detailed positional relationship between the auditory ossicles and to provide theoretic navigational guidelines for optimal prosthesis adaptation and effective malleostapedotomy.
Methods
Fifty sides of the temporal bone from donated cadavers were scanned by MicroCT and the malleus, incus, stapes and tympanic membrane were materialized three dimensionally using computer software. Dimensions between the auditory ossicles closely related to malleostapedotomy were measured twice.
Results
The grip site of malleus handle was mean 1.8 mm superior and mean 1.3 mm anterior, and linear distance between the grip site of malleus handle and the footplate of the stapes was mean 6.5 mm. The stapes was not parallel to the tympanic membrane and rotated mean 10.7° posteriorly relative to the tympanic membrane.
Conclusion
Surgeons should start with at least 8.75 mm prosthesis to cover the upper limits of potential anatomy and then trim down to the individualization to the case. The ideal loop morphology has to be oval shape more than 1.4 mm in the long diameter and 1.0 mm in the short diameter. The wire of the prosthesis has to be bended at the two points: about 10° anteriorly at the most proximal point of the wire and about 50° superiorly at the stapes head point.
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Acknowledgements
This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2018R1C1B5045507).
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KJS: project development, data collection, manuscript writing.
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Shin, KJ. Navigational guidelines and positional relationships of the human auditory ossicles from three-dimensional topography for ensuring safe and effective malleostapedotomy. Surg Radiol Anat 43, 153–159 (2021). https://doi.org/10.1007/s00276-020-02556-x
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DOI: https://doi.org/10.1007/s00276-020-02556-x