WO2010083699A1

WO2010083699A1 - Ossicular prosthesis

Info

Publication number: WO2010083699A1
Application number: PCT/CN2009/075325
Authority: WO
Inventors: 邹艺辉; 韩东一; 杨仕明
Original assignee: 中国人民解放军总医院
Priority date: 2009-01-24
Filing date: 2009-12-04
Publication date: 2010-07-29
Also published as: CN201379669Y

Abstract

An ossicular prosthesis includes an all-purpose connecting end (3), a stapes connecting end (1), and a connecting rod (2) for connecting the all-purpose connecting end (3) and the stapes connecting end (1).The stapes connecting end (1) is cup-shaped whose underside opening is elliptic, and a gap (14) is provided on the rear end of the cup for stapes tendon traversing. The all-purpose connecting end (3) is in the shape of mushroom head used when the incus and the malleus are both lost and the all-purpose connecting end (3) is in the shape of a fork used when the incus is lost.

Description

Artificial ossicle

Technical field

The invention relates to the field of medical instruments, in particular to artificial ossicles. Background of the invention

The human ossicle consists of a hammer bone, an anvil bone and a tibia. It is connected to each other to form a ossicular chain. It has the function of transmitting and amplifying sound, and is the basis for maintaining normal hearing of the human body. For various reasons, such as chronic otitis media, it can lead to continuous interruption of the ossicular chain or limited movement, affecting hearing.

Among them, the incus and the hammer bone are missing and the tibia remains, or only the incus is missing, causing the occlusion of the ossicular chain to cause deafness. It is very common in chronic otitis media. The treatment is usually the artificial ossicle or the osseous complex. Into the missing position, connected to the remaining part, restore the continuity of the ossicular chain, so that hearing can be restored.

1 is a schematic perspective view of a conventional artificial ossicle, as shown in FIG. 1, the existing artificial ossicle includes a tibia connection 1, a connecting rod 2, a universal connecting end 3, wherein the tibia connecting end 1 It is a cup cover with a round bottom surface, which is connected to the humerus on the humeral head. The universal connecting end 3 is a circular disc with a round hole. The connecting rod 2 is a solid or hollow cylindrical rod. 3 is fixedly connected to the tibia connecting end 1 by the connecting rod 2. The universal connecting end 3 can be used to replace the function of the anvil with the hammer stem and the hammer stem, or directly against the tympanic membrane, instead of the function of the anvil and the hammer bone.

The above artificial ossicle can be applied to all cases where the anvil and the hammer bone are missing, or only the incus is missing. Although it can replace the incus or replace the hammer bone and the anvil, it is used for the anvil and the bone. In the case of all missing, when the universal connecting end 3 is in contact with the tympanic membrane, the edge of the disc exerts a large pressure on the tympanic membrane, which is likely to cause perforation of the tympanic membrane; and in the case of the absence of the invisible bone, the universal connecting end 3 and The part of the hammer stem is connected to a plane, while the hammer stem is It has a long handle shape, and the difference in the shape of the connecting part may result in poor stability after artificial osseoinvasion and easy dislocation, resulting in surgical failure. In addition, the bottom surface of the tibial connection end is a circular cup cover, which is inconsistent with the physiological shape of the humerus itself, so that the stability of the connection with the tibia is affected, which may affect the sound transmission function of the ossicular chain. Summary of the invention

The embodiment of the invention provides an artificial hearing bone, which is used for the complete absence of the anvil and the hammer bone, so that the connection between the artificial hearing bone and the tibia is more stable, the sound transmission performance is better, and the pressure on the eardrum is small, It is easy to cause perforation of the eardrum.

The embodiment of the invention provides an artificial ossicular bone, which is used for the case where only the anvil is missing, which makes the connection between the artificial ossicle and the tibia more stable, and has better sound transmission performance, and has better stability after implantation. , not easy to dislocate.

The technical solution of the embodiment of the present invention is implemented as follows:

An artificial ossicle for the case where the anvil and the hammer are completely missing, including a universal connecting end, a tibia connecting end and a connecting rod connecting the universal connecting end and the tibia connecting end, wherein the universal connecting end is a peripheral edge circle A blunt mushroom-shaped head, the connecting end of the tibia is a cup cover having an open bottom surface, and a gap for the iliac crest is passed through the back of the cup cover.

An artificial ossicle for a case where only an anvil is missing, comprising a universal connecting end, a tibia connecting end, and a connecting rod connecting the universal connecting end and the tibia connecting end, wherein the universal connecting end is a forked head, The tibia connection end is a cup cover having an open bottom surface, and a gap for the iliac crest is passed through the back of the cup cover.

Preferably, the bottom of the universal connecting end is provided with a hollow sleeve, one end of the connecting rod is fixedly connected or integrally formed with the top of the cup cover at the connection end of the tibia, and the other end is inserted into the hollow sleeve and the universal connecting end. connection.

Preferably, the top of the cup cover at the connecting end of the tibia is provided with a hollow sleeve, one end of the connecting rod The bottom of the universal connecting end is fixedly connected or integrally formed, and the other end is connected to the connecting end of the tibia by inserting the hollow sleeve.

Preferably, the connecting rod is a hollow or solid cylindrical rod.

Preferably, the surface of the connecting rod is machined with a lateral groove or a scale line.

Preferably, the outer surface of the universal connecting end is a rough surface or covers a non-slip coating. Preferably, the inner surface of the cup cover of the tibial joint end is a rough surface or covers a non-slip coating. BRIEF DESCRIPTION OF THE DRAWINGS

1 is a schematic view showing a three-dimensional structure of a conventional artificial hearing bone;

2 is a schematic exploded view of a three-dimensional structure of an artificial ossicle for use in the absence of an anvil and a hammer bone according to an embodiment of the present invention;

Fig. 3 is an exploded perspective view showing the three-dimensional structure of an artificial auditory bone for an anvil deficiency only in the embodiment of the present invention. Mode for carrying out the invention

The present invention will be further described in detail below with reference to the accompanying drawings.

The embodiment of the invention is mainly used for the case where the anvil and the hammer bone are all missing, and the universal connecting end of the artificial hearing bone is designed with a rounded mushroom head shape at the outer peripheral edge, so that the universal connecting end of the artificial hearing bone can be smoothed. The contact with the tympanic membrane makes the artificial hearing bone exert less pressure on the tympanic membrane after implantation, and it is not easy to cause perforation of the tympanic membrane. In the case of the absence of the invisible bone, the universal connecting end of the artificial ossicular bone adopts a shape that can be matched with the shape of the hammer shank, that is, the fork-shaped design, so that the universal connecting end of the artificial anvil can be stuck on the hammer shank, so that The artificial incus has good stability after implantation and is not easy to dislocate. In addition, the elbow connection end adopts an elliptical cup cover design, which is more conformable to the physiological shape of the humeral head, and has a notch at the back of the cup cover to pass through the iliac tendon. The connection between the artificial hearing bone and the tibia is more stable, and the sound transmission performance is better. The connecting rod connects the universal connecting end and the tibia connecting end in a sleeve manner, so that the length can be adjusted according to actual surgical needs.

2 is a schematic exploded perspective view of an artificial ossicle for the absence of an anvil and a hammer bone according to an embodiment of the present invention. As shown in FIG. 2, the artificial ossicle includes a tibia connecting end 11, a connecting rod 12, and a universal connecting end 13.

The tibia connecting end 11 is a cup cover having an open bottom surface and is connected to the tibia on the humeral head. The size of the cup cover can be determined according to the structural characteristics and size of the normal human humeral head, for example: The length of the bottom surface is 1.3 mm, the short diameter is 1.0 mm, and the cup cover is 1.7 mm high. Slight adjustments can be made to the specific needs during surgery, such as clamping or distracting. The bottom of the cup cover is oval, which can better conform to the physiological shape of the humeral head, making the connection with the tibia more stable and better. In addition, the inner surface of the cup can also be non-slip treated, for example, roughened, or formed into granules, grooves, or the like, or covered with a non-slip coating to further prevent dislocation. In addition, a notch 14 may be further formed in the rear of the cup cover, and the notch 14 may be caught on the iliac tendon to further increase the stability of the connection between the tibial connector 11 and the tibia. The position, shape and size of the notch can be designed according to the shape and size of the iliac tendon, for example, a lmm x 1 mm notch can be opened at the back of the mouth of the cup.

The universal connector 13 is a mushroom head having a slightly flattened head with a slightly rounded top and a blunt (non-sharp) peripheral edge for contact with the tympanic membrane. The size of the mushroom head can be tailored to the needs, for example: The mushroom head has a diameter of 3 mm and a height of lmm. During the operation, it can be adjusted according to specific needs, such as flattening the mushroom head. The universal connecting end 13 adopts a mushroom-shaped head shape, and the outer peripheral edge is round and blunt, and the contact edge portion with the eardrum does not exert excessive tension on the eardrum, so that the pressure of the artificial ear bone on the eardrum after implantation is small, and it is not easy to cause The tympanic membrane is perforated, and the outer surface of the mushroom-shaped head can also be non-slip treated or covered with a non-slip coating, further increasing the stability of the universal connecting end 13 in contact with the tympanic membrane.

In this embodiment, the bottom of the mushroom head of the universal connecting end 13 is further provided with a hollow sleeve. The hollow sleeve is for connection to the connecting rod 12.

One end of the connecting rod 12 is fixedly connected to the top end of the cup end of the tibial connection end 11, such as welding or integral molding, and the other free end can be connected to the universal connecting end 13 through a hollow sleeve inserted into the universal connecting end 13. The length of the connecting rod 12 can be made slightly longer than the normal human humeral head to the tympanic membrane at the time of manufacture, and is shortened at the time of surgery according to the actual length required by the patient. The size of the connecting rod 12 should also match the size of the hollow sleeve so that it can be inserted into the hollow sleeve, for example: the connecting rod 12 is 3.3 mm long, the free end is 0.7 mm in diameter, the hollow sleeve is 1.5 mm long, and the inner diameter is 0.8. Mm.

In addition, the hollow sleeve may also be disposed at the top of the cup cover of the tibia connecting end 11, and one end of the connecting rod 12 is fixedly connected or integrally formed with the bottom of the mushroom head of the universal connecting end 13, and the other end is inserted into the hollow sleeve and the tibia. The connection terminal 11 is connected.

The connecting rod 12 can be a hollow or solid cylindrical rod, and the surface can also be machined with lateral grooves or tick marks. The grooves or tick marks facilitate the intercepting of the connecting rod 12 and control the length of the artificial hearing bone.

The artificial ossicle of the present invention has a universal connecting end 13 and a tibia connecting end 11 connected by a connecting rod in a sleeve manner, so as to adjust the total of the artificial ossicular bone by shortening the connecting rod 12 according to the specific condition of each patient. The length, or replacement of the universal connection for different ossicular missing conditions, allows the artificial ossicle to adapt to a variety of surgical conditions. Of course, the universal connecting end 13 can also be fixedly connected or integrally formed with the tibial connecting end 11 through the connecting rod 12, etc., but in the form of the unchangeable length, it is necessary to manufacture artificial bones of various lengths and different universal connecting ends. To adapt to different surgical conditions.

FIG. 3 is a perspective exploded view of an artificial ossicle for an anvil deficiency only according to an embodiment of the present invention. As shown in FIG. 3, the artificial ossicle includes a tibia connecting end 21, a connecting rod 22, a universal connecting end 23, and a notch 24.

The specific structure of the connecting rod 22, the tibia connecting end 21 and the notch 24 is the same as that in FIG. The specific structure and function of the rod 12 and the tibia connecting end 11 and the notch 14 are the same and will not be described again. In the present embodiment, the universal connecting end 23 is a forked head for catching the hammer stem. The size of the fork head can be determined according to the structural characteristics and size of the normal human hammer stem. For example, the distance between the fork ends is 1 mm and the fork height is 1 mm. During operation, it can be adjusted slightly according to specific needs, such as clamping or distracting the bifurcation of the fork head. The universal connecting end 23 adopts a fork-shaped head shape, so that the universal connecting end 23 can be stuck on the hammer stem, and the hammer stem The connection is more stable and not easy to dislocate. The inner surface of the fork head can also be non-slip or covered with a non-slip coating to further prevent dislocation. In addition, the bottom of the fork head of the universal connecting end 23 is also provided with a hollow sleeve for connection to the connecting rod 22.

It can be seen from the above embodiments that the universal connecting end of the present invention adopts an artificial ossicular bone in the form of a mushroom head, and in the case where all the anvil and the hammer bone are missing, the contact portion of the universal connecting end of the artificial ossicular bone and the tympanic membrane can be made. It is relatively smooth, which makes the artificial hearing bone exert less pressure on the tympanic membrane after implantation, and it is not easy to cause perforation of the tympanic membrane, and it will not affect the hearing. The universal connecting end adopts the artificial ossicle in the form of a fork-shaped head. In the case of the absence of the invisible bone, the universal connecting end of the artificial ossicular bone can be stuck on the hammer shank, so that the artificial ossicular bone has better stability after implantation. , not easy to dislocate. In addition, the oval cup cover is more conformable to the physiological shape of the humeral head, and a gap is formed in the back of the cup cover to pass through the iliac tendon, which makes the connection between the artificial ossicle and the tibia more stable, and the sound transmission performance. better. The connecting rod connects the universal connecting end and the tibia connecting end in a sleeve manner, so that the length can be adjusted according to actual surgical needs.

It is to be understood that the foregoing is only a preferred embodiment of the present invention, and is not intended to limit the scope of the invention, any modifications, equivalents, Improvements and the like should be included in the scope of the present invention.

Claims

Claim

1. An artificial ossicle for use in the absence of an anvil and a hammer bone, comprising a universal connecting end, a tibia connecting end, and a connecting rod connecting the universal connecting end and the tibia connecting end, wherein the universal connection The end is a mushroom-shaped head having a blunt peripheral edge, and the connecting end of the tibia is a cup cover having an open bottom surface, and a notch for the tibia is passed through the back of the cup cover.

2. An artificial ossicle for use in the case of only an anvil missing, comprising a universal connecting end, a tibia connecting end, and a connecting rod connecting the universal connecting end and the tibia connecting end, wherein the universal connecting end is a The fork head, the connecting end of the tibia is a cup cover having an open bottom surface, and the back of the cup cover is provided with a gap for the iliac tendon to pass through.

The artificial ossicle according to claim 1 or 2, wherein the bottom of the universal connecting end is provided with a hollow sleeve, and one end of the connecting rod is fixedly connected or integrally formed with the top of the cup cover at the connecting end of the tibia. The other end is connected to the universal connecting end by inserting the hollow sleeve.

The artificial ossicle according to claim 1 or 2, wherein a top of the cup end of the tibia is provided with a hollow sleeve, and one end of the connecting rod is fixedly connected or integrally formed with the bottom of the universal connecting end. The other end is connected to the tibial connection end by insertion of the hollow sleeve.

The artificial ossicle according to claim 1 or 2, wherein the connecting rod is hollow or solid cylindrical.

The artificial ossicle according to claim 1 or 2, wherein the surface of the link is machined with a transverse groove or a scale line.

The artificial ossicle according to claim 1 or 2, wherein the outer surface of the universal joint is a rough surface or a non-slip coating.

The artificial ossicle according to claim 1 or 2, wherein the inner surface of the cup cover at the connecting end of the tibia is a rough surface or a non-slip coating.