title: Optimum tension for partial ossicular replacement prosthesis reconstruction in the human middle ear.
abstract: OBJECTIVE
  Hearing results from ossiculoplasty are unpredictable. There are many potentially modifiable parameters. One parameter that has not been adequately investigated in the past is the effect of tension on the mechanical functioning of the prosthesis. Our goal was to investigate this parameter further, with the hypothesis that the mechanical functioning of partial ossicular replacement prostheses (PORP) from the stapes head to the eardrum will be affected by the tension that they are placed under.
  
  
  METHODS
  Fresh temporal bones were used to reconstruct a missing incus defect with a PORP-type prosthesis. Three different lengths of PORP were used, and the stapes vibrations were measured with a laser Doppler vibrometer using a calibrated standard sound in the ear canal. Eight temporal bones were used.
  
  
  RESULTS
  Tension had a very significant effect on stapes vibration. In general, loose prostheses resulted in the best overall vibration transmission. The effects were most marked at the lower frequencies. There was a slight advantage to tight prostheses in the higher frequencies, but much less than the decrement in lower frequencies with tight prostheses.
  
  
  CONCLUSIONS
  In ossicular reconstruction, best stapes vibration results in our model are achieved by shorter prostheses, which result in lower tension.
authors.affiliation: Ear & Auditory Research Laboratory, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: David P
authors.initials: DP
authors.lastname: Morris
authors.forename: Manohar
authors.initials: M
authors.lastname: Bance
authors.forename: Rene G
authors.initials: RG
authors.lastname: van Wijhe
authors.forename: Michael
authors.initials: M
authors.lastname: Kiefte
authors.forename: Rachael
authors.initials: R
authors.lastname: Smith
mesh_terms: D002102:Cadaver; D004432:Ear, Middle / Q000601:surgery*; D006801:Humans; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods*; D014732:Vibration