Prosthetics in the Middle Ear: Preliminary Report on the Use of Prosthetics to Reestablish Continuity of the Sound Pressure Transformer of the Middle Ear

Abstract

The advent of stapes mobilization and tympanoplastic procedures has introduced the problem of restoring the continuity of the middle ear sound-conducting apparatus when this has been interrupted by disease, congenital malformation, or stapedial fracture. This preliminary report describes methods for reestablishing ossicular continuity using polyethylene tubing or tantalum wire alone or in combination. Rationale It is remarkable that the two essential requisites for normal functioning of the middle ear, namely sound protection for the round window and sound pressure transformation for the oval window, were not clearly appreciated by clinicians until a scant decade ago. Eighty years before this, Helmholtz¹ defined the purpose of the ossicular chain linking large tympanic membrane to small oval window as a mechanism to transform air-borne sound vibrations of large amplitude but small force into fluid-borne vibrations of small amplitude but large force. Recent investigations by Békésy² confirm the essential concepts of Helmholtz,