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Peer-reviewedCC BY 4.0Frontiers in Bioengineering and Biotechnology

Finite element evaluation of a novel adjustable-length partial ossicular replacement prosthesis

  1. 1Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
  2. 2Department of Skull Base Surgery Center, Huanhu Hospital Affiliated to Tianjin Medical University, Tianjin, China

Abstract

Purpose: Partial ossicular replacement prosthesis (PORP) reconstruction is a standard otologic procedure for restoring sound conduction in patients with conductive hearing loss resulting from partial ossicular chain disruption. Current commercial PORP designs exhibit several limitations that may affect long-term hearing outcomes and contribute to complication risks. This study presents a novel adjustable-length PORP and systematically evaluates its biomechanical performance and sound transmission fidelity using a finite element analysis (FEA) framework, thereby providing computational evidence for preclinical feasibility evaluation.

Methods: The proposed prosthesis incorporates a deformable bent titanium alloy connecting rod sandwiched between two polyetheretherketone (PEEK) coupling components: a tympanic-side circular disc and a stapes-head bowl. The connecting rod incorporates three independently adjustable bend angles (α, β, γ) that enable intraoperative alignment optimization. An FEA model of the intact human middle ear was constructed, and baseline vibratory transmission characteristics were quantified using the stapes footplate frequency response curve. An FEA model of the middle ear reconstructed with the novel adjustable-length PORP was then generated, and vibratory conduction performance was quantified across continuous length settings spanning 2.3–3.5 mm.

Results: Across the evaluated length range of 2.4–3.5 mm, the prosthesis demonstrates consistent stapes footplate velocity transmission, with predicted hearing loss remaining below 17 dB across the 100 Hz–10 kHz frequency range. Adjusting the prosthesis to the minimum 2.3 mm length increased maximum hearing loss to 34 dB, consistent with structural overcompression.

Conclusion: This finite element analysis provides computational evidence which suggesting the preclinical biomechanical feasibility of the proposed adjustable-length PORP for ossicular chain reconstruction. The predicted results suggest potentially acceptable sound transmission performance and favorable mechanical conditions at the prosthesis-bone interfaces. These findings warrant further experimental validation using physical middle ear models and animal studies to assess long-term safety and functional outcomes.

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BibTeX
@article{liu2026finite,
  title = {{Finite element evaluation of a novel adjustable-length partial ossicular replacement prosthesis}},
  author = {Qingsong Liu and Xiao Qin and Songbo Xue and Zhiqiang Gao and Guodong Feng},
  journal = {Frontiers in Bioengineering and Biotechnology},
  year = {2026},
  month = oct,
  doi = {10.3389/fbioe.2026.1956560},
  url = {https://doi.org/10.3389/fbioe.2026.1956560},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Finite element evaluation of a novel adjustable-length partial ossicular replacement prosthesis
AU  - Qingsong Liu
AU  - Xiao Qin
AU  - Songbo Xue
AU  - Zhiqiang Gao
AU  - Guodong Feng
PY  - 2026
DA  - 2026/10/12
JO  - Frontiers in Bioengineering and Biotechnology
DO  - 10.3389/fbioe.2026.1956560
UR  - https://doi.org/10.3389/fbioe.2026.1956560
AB  - Purpose: Partial ossicular replacement prosthesis (PORP) reconstruction is a standard otologic procedure for restoring sound conduction in patients with conductive hearing loss resulting from partial ossicular chain disruption. Current commercial PORP designs exhibit several limitations that may affect long-term hearing outcomes and contribute to complication risks. This study presents a novel adjustable-length PORP and systematically evaluates its biomechanical performance and sound transmission fidelity using a finite element analysis (FEA) framework, thereby providing computational evidence for preclinical feasibility evaluation.  Methods: The proposed prosthesis incorporates a deformable bent titanium alloy connecting rod sandwiched between two polyetheretherketone (PEEK) coupling components: a tympanic-side circular disc and a stapes-head bowl. The connecting rod incorporates three independently adjustable bend angles (α, β, γ) that enable intraoperative alignment optimization. An FEA model of the intact human middle ear was constructed, and baseline vibratory transmission characteristics were quantified using the stapes footplate frequency response curve. An FEA model of the middle ear reconstructed with the novel adjustable-length PORP was then generated, and vibratory conduction performance was quantified across continuous length settings spanning 2.3–3.5 mm.  Results: Across the evaluated length range of 2.4–3.5 mm, the prosthesis demonstrates consistent stapes footplate velocity transmission, with predicted hearing loss remaining below 17 dB across the 100 Hz–10 kHz frequency range. Adjusting the prosthesis to the minimum 2.3 mm length increased maximum hearing loss to 34 dB, consistent with structural overcompression.  Conclusion: This finite element analysis provides computational evidence which suggesting the preclinical biomechanical feasibility of the proposed adjustable-length PORP for ossicular chain reconstruction. The predicted results suggest potentially acceptable sound transmission performance and favorable mechanical conditions at the prosthesis-bone interfaces. These findings warrant further experimental validation using physical middle ear models and animal studies to assess long-term safety and functional outcomes.
SN  - 2296-4185
ER  -