EP0077370A1 - Prothese de la paroi du conduit auditif et procede pour sa fabrication - Google Patents

Prothese de la paroi du conduit auditif et procede pour sa fabrication

Info

Publication number
EP0077370A1
EP0077370A1 EP82901402A EP82901402A EP0077370A1 EP 0077370 A1 EP0077370 A1 EP 0077370A1 EP 82901402 A EP82901402 A EP 82901402A EP 82901402 A EP82901402 A EP 82901402A EP 0077370 A1 EP0077370 A1 EP 0077370A1
Authority
EP
European Patent Office
Prior art keywords
canal wall
prosthesis according
auditory canal
cuff
bio
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP82901402A
Other languages
German (de)
English (en)
Inventor
Ralf Reck
Heinz BRÖMER
Klaus Deutscher
Henning Franek
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ernst Leitz Wetzlar GmbH
Original Assignee
Ernst Leitz Wetzlar GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from DE19813117025 external-priority patent/DE3117025A1/de
Priority claimed from DE19823211212 external-priority patent/DE3211212A1/de
Application filed by Ernst Leitz Wetzlar GmbH filed Critical Ernst Leitz Wetzlar GmbH
Publication of EP0077370A1 publication Critical patent/EP0077370A1/fr
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/28—Materials for coating prostheses
    • A61L27/30—Inorganic materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/18—Internal ear or nose parts, e.g. ear-drums
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/18—Internal ear or nose parts, e.g. ear-drums
    • A61F2002/183—Ear parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/14—Materials or treatment for tissue regeneration for ear reconstruction or ear implants, e.g. implantable hearing aids

Definitions

  • the invention relates to a prosthesis for the total or partial replacement of the posterior auditory canal wall and a method for its production.
  • the task is to provide a prosthesis shape that is analogous to the actual anatomical conditions, to solve the material problem for the intended prosthesis in an optimal manner, and means on the prosthesis for anatomically and geometrically exact preparation and positioning of the prosthesis on the implant place of provision.
  • the invention is also based on the object of designing those partial surface areas of the present prosthesis that are not intended for the actual bond with the bone (intergrowth zone: implant / bony hard tissue) in such a way that they are completely biochemically resistant and bioinactive.
  • the task consists in specifying a method for the subsequent bio-inactivation of selected partial areas, in themselves bioactive prostheses or prosthesis parts.
  • a prosthesis of the type mentioned at the outset in that it has the shape of a non-closed, hollow-cylindrical sleeve with different widenings, at least in its two base areas, in the manner of a hyperboloid, preferably with an elliptical cross section, and in that it consists of bioactive material.
  • its inner wall has a spatial coordinate grid.
  • the grid can consist of two intersecting sets of lines, the one of the two sets consisting of a multiplicity of hyperbiform lines which run essentially in the direction of the axis of the cuff and the other of the two sets consisting of a multiplicity of elliptical, essentially vertical Lienien to the axis of the cuff.
  • the lines of the coordinate grid can be formed as groove-shaped depressions any cross-sectional shape - for example triangular, square, rounded, etc. - be formed. It is also possible to design the lines of the coordinate grid as bead-like elevations.
  • discontinuous, periodically arranged grids for example dimples or nubs, can be provided instead of continuous lines.
  • the positive embodiment of the grid consist of the same material as the prosthesis itself.
  • the average mesh size of the coordinate grid is between 1 and 2 mm.
  • the length of the cuff cutout is advantageously greater than its mean peripheral distance and the shortest of all the main axes of those inner ellipses that pass through
  • Cuts perpendicular to the axis of the cuff are longer than the average peripheral distance of the cuff cutout.
  • the dimensioning can be such that the length of the cuff to the two jacket interfaces, at which the cuff cutout is separated out, continuously increases and reaches its maximum there, while its minimum is reached in the jacket area opposite the cutout.
  • the wading thickness of the cuff is between 0.5 and 2.0 mm
  • the average length of the cuff is between 12 and 25 mm
  • the average peripheral distance of the cuff cutout is between 7 and 14 mm
  • the average Length of Major ellipse axes between 10 and 17 mm
  • the average length of the minor ellipse axes between 5 and 8 mm
  • the positive or negative grid has an average height or depth between 0.2 and 1.0 mm.
  • the bioactive material used is preferred
  • the proposed prosthesis consists of a core material that has a coating with bioactive substances.
  • the auditory canal wall prosthesis can also consist of only a part of the entire cuff, in particular a section of a mansheath jacket or a part thereof.
  • the object is further achieved in a prosthesis of the type mentioned at the outset in that it additionally contains insoluble bio-inert material in at least one partial surface area or partially has a coating of insoluble bio-inert material.
  • the coating can consist of at least one additively applied protective layer with a thickness between 0.25 and 10 ⁇ m or at least one subtractive conversion layer with a thickness between 0.25 and 5 ⁇ m. It is also possible for the coating to additively slide on from at least one conversion core generated on the prosthesis core side and at least one on top of it brought protective layer exists. At least the inner wall and / or the outer wall of the sleeve advantageously consists of insoluble bio-inert material.
  • the bio-inert material or the bio-inert layer can consist of at least one of the following substances: metals, such as gold, platinum, titanium, and metal alloys; Carbon in suitable modifications, such as pyrolytic carbon (graphite); Carbon compounds such as silicon carbide (SiC), titanium carbide (TiC), boron carbide (B 4 C); Special ceramic materials, such as hexagonal boron nitride (BN), titanium nitride (TN), silicon nitride (Si 3 N 4 ); semi-crystalline inorganic composite systems, such as enamels; inorganic one-component (eg silica glass) or multi-component glasses; Oxides such as titanium dioxide (TiO 2 ), zirconium dioxide (ZrO 2 ) and aluminum oxide (Al 2 O 3 ).
  • the bio-inert material or the bio-inert layer consists of a (m)
  • Bio glass ceramic or bio ceramic or bio glass which optionally also has a silane layer.
  • the partial areas of the cuff to be treated are subjected to a targeted post-treatment with surface treatment to produce at least one additively applied, permanently fixed, bio-inert protective layer which acts in vivo as a biochemical barrier layer.
  • a coating to provide a method in which the relevant parts of the cuff or the cuff part are subjected to a chemical aftertreatment with the targeted removal of substances or exchange of substances to produce at least one self-absorbing, permanently adherent, bioinert conversion (leaching) layer which acts as a biochemical barrier layer in vivo .
  • the additive protective layer can preferably be applied by at least one of the following process steps: electroplating or vapor deposition; Sputtering; Separation from organic solutions or evaporation in vacuo; Dipping, spraying or sprinkling with subsequent thermal treatment; Immersion in water glass with subsequent heating to approx. 400oC or immersion glazing from single or multi-component melt batches; Simultaneous evaporation or evaporation of the metals with subsequent oxidation treatment.
  • the subtractive protective layer can be obtained according to the present invention by treating the outer surface to be coated with aqueous, acidic solutions or with aqueous salt solutions with normalities between 0.001 and 0.1 between 5 minutes and 3 hours at temperatures between 20 and 100 ° C.
  • aqueous, acidic solutions or with aqueous salt solutions with normalities between 0.001 and 0.1 between 5 minutes and 3 hours at temperatures between 20 and 100 ° C.
  • 0.1 - 0.001 normal hydrochloric acid (HCl) or 0.001 to 0.25 normal standard acetate buffer solution can be used as the aqueous, acidic solution.
  • FIG. 1 a perspective view of a total auditory canal wall prosthesis (“cuff”);
  • FIG. 2a a representation analogous to FIG. 1, but with a graphic highlighting of the cuff section;
  • Fig. 2b a section through that shown in Fig. 2a along the line A-A;
  • 3 a representation analogous to FIG. 1, but with a graphic highlighting of a part of a cuff section (partial auditory canal wall prosthesis);
  • 4a an illustration analogous to FIG. 1
  • 4b shows a section through that shown in FIG. 4a along the line AA;
  • 5a a representation corresponding to FIG. 1, but with an additional additive coating also on the two long sides of the cuff;
  • 5b a section through that shown in FIG. 5a along the line AA;
  • FIG. 1 shows a total auditory canal wall prosthesis according to the present invention in perspective, enlarged form. To describe the complicated geometric spatial shape, the schematic representations of FIGS. 2a and 2b are used as the starting point.
  • FIG. 2a shows the front cutout in dashed lines in FIG. 2a. If one also imagines the front cutout in dashed lines in FIG. 2a, this results in a closed, hollow-cylindrical sleeve with a cross-sectional area deviating from a circular shape. If a plurality of cuts that are perpendicular to the cuff axis 2 are placed through the cuff, the areas of immediately adjacent cuts have different areas.
  • FIG. 2b shows the area with a minimum area F min , which was generated by a section along the line AA in FIG. 2a.
  • the closed cuff is in its upper region - that is, in the direction of the upper Cuff rim 9 - widened more than in its lower area.
  • a characteristic feature of the initial geometric shape is the slight waistline in the middle area of the cuff and the widening to different extents in both end areas.
  • the final prosthetic shape according to the invention for a total implant is obtained by making two "cuts" along the lateral surface in an essentially axial direction and removing the cuff cutout 3 obtained in this way, so that the cuff cutout 3 shown in FIG. 1 shown open cuff shape is obtained.
  • the (axial) long sides 4 of the cuff 1 or the cuff cutout 3 are larger than its central peripheral distance 5.
  • the minimum peripheral distance can be seen from the hatched part of FIG. 2b.
  • the maximum peripheral distance is in the upper cuff area, which is the widest. If you place a cuff on the cuff indicated in dashed lines in FIG. 2a, in both its upper and in its lower end area, so that it lies on the respectively assigned cuff edge 9 or 10, then the cuff axis 2 stands on this imaginary planes not perpendicular. Both levels run - preferably - not exactly parallel to each other.
  • the wall thickness of the sleeve 1 is essentially constant. However, slight bulges or thickenings in their termination areas are also possible.
  • An essential feature of the invention of the proposed auditory canal wall prosthesis is that it - preferably over the entire area of its inner wall 11 - has a grid 6.7, which consists of two sets of intersecting lines 6 and 7, respectively.
  • the lines 6 of the first family run hyperbolic in the axial direction and the lines 7 of the second family elliptical in the peripheral direction, so that the lines of both systems intersect at an angle of approximately 90.
  • Borrowed lines are shown, but in reality they are relief-like, three-dimensional identifiers.
  • the cross section of these preferably uniform depressions can be rectangular, square, trough-shaped, acute-angled, etc.
  • relief-like elevations for example beads, can also be provided on the inside surface of the cuff.
  • Linear extension can also be provided for positive (relief-like) and negative (recesses) discontinuous "line" groups, for example (positive) knobs or (negative) dimples.
  • the dimensioning of the coordinate grid applies that its mesh size is at least twice as large as the transverse dimension of the positive or negative "lines”. Grids other than those shown in FIG. 1, for example those with diamond-shaped meshes, are also possible.
  • the entire duration of the osteosurgical intervention can be shortened considerably.
  • the surgeon is now in a position, by means of a few preoperative fitting attempts, namely by bringing the total implant to the area of the auditory canal wall that it can be re-inserted through a surgical intervention design applies, and by simultaneously estimating the surface areas of the prosthesis that are subsequently to be removed by grinding, to provide an optimally adapted implant shape that corresponds to the individual requirements of each patient.
  • Shadow formation on the lines of the grid is emphasized by such oblique lighting.
  • the positive raster identifiers consist of the same biomaterial as the prosthesis itself. Also in the case of the negative raster identifiers, no additional, for example differently colored, optical contour reinforcements are provided.
  • Bioactive glass ceramic such as is described in detail in DE-PS 23 26 100, can be used as the material.
  • Other suitable materials are bioactive composite materials based on sintered products containing apatite, which are known from DE-PS 23 46 739 and DE-PS 24 34 979.
  • polymeric bioactive composite materials can be used, as are protected by DE-PS 25 01 683.
  • FIG. 3 the cuff 1 shown in FIG. 1 is again shown in dashed form.
  • Part 8 of a cuff section is shown in solid lines. This is understood to mean a peripheral section part which runs essentially perpendicular to the cuff axis 2.
  • various other forms of cuff sections or cuff cutouts from or from the total prosthesis 1 given as spatial shape are also possible.
  • Fig. 3 only part of such a sleeve section is shown.
  • This part 8 represents a partial implant for partial ⁇ reconstruction of the rear part of the auditory canal wall.
  • the internal grid which is also present per se, has been omitted here.
  • biomaterial as a material for the prosthesis according to the invention offers particular advantages, particularly in the field of middle ear surgery, which have been described in detail in German patent application P 30 36 245.9.
  • bioactive bone substitute materials in particular bio glass or bio glass ceramic - have a certain surface solubility, which presumably represents a prerequisite for the formation of the bone / implant combination.
  • this special property under particularly unfavorable local anatomical conditions, such as are particularly given when implanting a prosthesis in the soft tissue store or when such a prosthesis comes into contact with soft tissue, can have the effect that the long-term stability of the implant is impaired.
  • the property is bioactivity is achieved by special chemical composition of the implant material, such a material for implantation in other tissues is not particularly advantageous. For example, it can be observed that the implantation of bioactive material triggers stronger sensitive reactions in the soft tissue than a bioinert material.
  • the auditory canal wall prosthesis according to the invention comes into direct contact with bony tissue in the area of the upper and lower cuff edges 9 and 10, these surface areas are not bioinactivated.
  • the inner wall 11 and / or the outer wall 12 and / or the two long sides 4 can have a bio-inert, insoluble protective slide in part or in full.
  • Such a layer - namely an additive protective layer S (+) - is shown in FIG. 4a. It covers the inner wall 11 (combination reference symbol: “11 (S (+))”) and the outer wall 12 (combination reference symbol: “12 (S (+))”). Since the protective layer S (+) already achieves its inactivating effect with very small layer thicknesses, the application of such an additive coating does not optically "cover up” the grid on the basic shape.
  • FIG. 6 shows a section along the imaginary line AA in the case of a sleeve which has a geometrically non-bulky, bioinert, insoluble, subtractive layer S (-) in the inner and outer walls 11 and 12 (combination reference symbol: "11 (S (-)) “and” 12 (S (-)) ").
  • FIG. 7 An example is shown in FIG. 7, in which the long sides were additionally subtractively coated (“4 (S (-))”).
  • Both - the additive and the subtractive - protective layers S (+) and S (-) have the same functions. To a certain extent, they represent biochemical "corrosion" protective layers that guarantee complete transport and passage barriers for any material (ion) exchange between the chemical components of the implant and the components of the physiological-biochemical body fluids.
  • a subtractive protective layer S (-) can be obtained in vitro in that, in the case of an implant consisting of solid bioglass-ceramic material or bioglass material, those surface partial areas that are forcibly - that is, due to anatomical conditions - or are desired by the otosurgeon - for example, when certain are undressed Implant areas with epithelial tissue - with soft tissue in Permanent contact occurs, chemically pretreated in such a way that aqueous acidic solutions and / or aqueous salt solutions in normalities between 0.001 and 0.1 attack the original bioglass-ceramic surface, attack (dissolution or leaching) and exchange reactions taking place side by side with the result that there is first a depletion and finally a complete destruction (transformation) of a phase - in particular the crystalline component (s) - of the glass-ceramic composite system.
  • bases and buffer systems can also be used for the chemical attack which, depending on their specific chemistry, their concentration and their P H value, act specifically on certain
  • the glass ceramic remaining after this combined chemical treatment, which has been stripped of its apatite components, is referred to as "residual bioglass ceramic".
  • residual bioglass ceramic With regard to its chemical properties, it is insoluble, non-porous and stops all ion transport; it is bioinactive with respect to its biochemical-physiological effect, ie bio- "inert", and with regard to its mechanical properties it is resistant to abrasion and adheres firmly to the prosthesis core material.
  • the creation of a subtractive layer S (-) does not change the total volume of the implant. Find it rather chemical exchange or transformation processes take place in the surface areas, which are directed "inwards" to a certain extent.
  • the additive layers S (+) shown in FIGS. 4a-5b are located on the implant surface, so that the total volume of the coated prostheses (FIGS. 4a and 5a) has been increased somewhat.
  • the subtractive layer S (-) can also be thermally compressed or sealed.
  • a silahization slide can also be applied in the bio-inert coating area.

Abstract

La prothese est destinee a la reconstruction partielle ou totale de la partie posterieure du conduit auditif. Elle presente la forme d'une manchette cylindrique non fermee (1) dont au moins les surfaces d'extremite (9) et (10) sont differemment ecartees pour former un hyperboloide de section avantageusement elliptique. La matiere constitutive est de preference un materiau bioactif. La paroi interieure (11) de la prothese forme un reseau (spatial) de coordonnees (6, 7) positif ou negatif. Des parties determinees de surfaces superieures (11, 12; 4) peuvent etre prevues avec une couche de protection insoluble et biologiquement inerte. Il peut s'agir d'une couche de protection additive ou d'une couche de protection soustractive. Pour les deux variantes, on utilise des procedes et des substances de revetement appropries. Dans le cas de la production de couches soustractives, celles-ci recoivent en plus un traitement subsequent de scellement et/ou de silanisation.
EP82901402A 1981-04-29 1982-04-29 Prothese de la paroi du conduit auditif et procede pour sa fabrication Pending EP0077370A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
DE3117025 1981-04-29
DE19813117025 DE3117025A1 (de) 1981-04-29 1981-04-29 Gehoergangswand-prothese
DE3211212 1982-03-26
DE19823211212 DE3211212A1 (de) 1982-03-26 1982-03-26 Gehoergangswand-prothese und verfahren zu ihrer herstellung

Publications (1)

Publication Number Publication Date
EP0077370A1 true EP0077370A1 (fr) 1983-04-27

Family

ID=25792946

Family Applications (2)

Application Number Title Priority Date Filing Date
EP82103647A Expired EP0064277B1 (fr) 1981-04-29 1982-04-29 Prothèse de conduit additif externe en forme d'un corps creux et son procédé de fabrication
EP82901402A Pending EP0077370A1 (fr) 1981-04-29 1982-04-29 Prothese de la paroi du conduit auditif et procede pour sa fabrication

Family Applications Before (1)

Application Number Title Priority Date Filing Date
EP82103647A Expired EP0064277B1 (fr) 1981-04-29 1982-04-29 Prothèse de conduit additif externe en forme d'un corps creux et son procédé de fabrication

Country Status (4)

Country Link
US (1) US4608051A (fr)
EP (2) EP0064277B1 (fr)
JP (1) JPS58500552A (fr)
WO (1) WO1982003765A1 (fr)

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DE3211209A1 (de) * 1982-03-26 1983-11-17 Ernst Leitz Wetzlar Gmbh, 6330 Wetzlar Gehoerknoechelchen-prothese und verfahren zu ihrer herstellung
US5387247A (en) * 1983-10-25 1995-02-07 Sorin Biomedia S.P.A. Prosthetic device having a biocompatible carbon film thereon and a method of and apparatus for forming such device
US5084151A (en) * 1985-11-26 1992-01-28 Sorin Biomedica S.P.A. Method and apparatus for forming prosthetic device having a biocompatible carbon film thereon
IT1196836B (it) * 1986-12-12 1988-11-25 Sorin Biomedica Spa Protesi in materiale polimerico con rivestimento di carbonio biocompatibile
US4888017A (en) * 1987-07-15 1989-12-19 The Cleveland Clinic Foundation Apparatus of controlling eustachian tube function
US5611347A (en) * 1989-07-25 1997-03-18 Smith & Nephew, Inc. Zirconium oxide and zirconium nitride coated percutaneous devices
US5152794A (en) * 1989-07-25 1992-10-06 Smith & Nephew Richards Inc. Zirconium oxide and nitride coated prothesis for reduced microfretting
US5370694A (en) * 1989-07-25 1994-12-06 Smith & Nephew Richards, Inc. Zirconium oxide and nitride coated endoprostheses for tissue protection
US5628790A (en) * 1989-07-25 1997-05-13 Smith & Nephew, Inc. Zirconium oxide zirconium nitride coated valvular annuloplasty rings
US5258022A (en) * 1989-07-25 1993-11-02 Smith & Nephew Richards, Inc. Zirconium oxide and nitride coated cardiovascular implants
US5496359A (en) * 1989-07-25 1996-03-05 Smith & Nephew Richards, Inc. Zirconium oxide and zirconium nitride coated biocompatible leads
FR2721199B1 (fr) * 1994-06-20 1996-11-22 Magnan Prothèse de conduit auditif externe.
FR2724309A1 (fr) * 1994-09-14 1996-03-15 Procerati Element d'ancrage de prothese
US5876447A (en) * 1996-02-14 1999-03-02 Implantech Associates Silicone implant for facial plastic surgery
US5797834A (en) * 1996-05-31 1998-08-25 Resound Corporation Hearing improvement device
FR2769493B1 (fr) * 1997-10-10 1999-12-17 Nogitek Sa Prothese de conduit auditif externe, plaque pour la realisation d'une telle prothese et procede de realisation d'une telle prothese
US6372283B1 (en) * 1999-04-02 2002-04-16 Medtronic, Inc. Plasma process for surface modification of pyrolitic carbon
CN101579266B (zh) * 2009-06-10 2011-03-23 中国人民解放军总医院 外耳道后壁赝复体
CN101933853B (zh) * 2009-12-16 2013-05-08 中国人民解放军总医院 外耳道模型支架
WO2013030787A1 (fr) * 2011-08-30 2013-03-07 Aduro Materials Ab Implants ayant des revêtements résistant à l'usure et procédés associés
DE102018104839A1 (de) * 2018-03-02 2019-09-05 Friedmar Hütter Ohrimplantat
CN110979740B (zh) * 2019-11-15 2021-06-11 北京宇航系统工程研究所 一种双曲面斜筋无蒙皮复合材料网格结构及其成型工装

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Also Published As

Publication number Publication date
JPS58500552A (ja) 1983-04-14
US4608051A (en) 1986-08-26
WO1982003765A1 (fr) 1982-11-11
EP0064277A1 (fr) 1982-11-10
EP0064277B1 (fr) 1986-03-19

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