Comparison of the Mechanical Performance of Ossiculoplasty Using a Prosthetic Malleus-to-Stapes Head with a Tympanic Membrane-to-Stapes Head Assembly in a Human Cadaveric Middle Ear Model
Bibliographic record
Abstract
HYPOTHESIS: Ossiculoplasty using prosthetic reconstruction with a malleus assembly to the stapes head will result in better transmission of vibrations from the eardrum to the stapes footplate than reconstruction with a tympanic membrane assembly to the stapes head. Both types of reconstruction will be affected by tension of the prosthesis. BACKGROUND: Theories (and some clinical studies) that the shape of the normal tympanic membrane is important suggest that prosthetic reconstruction to the malleus performs better than reconstruction to the tympanic membrane. This has not been previously tested by directly measuring vibration responses in the human ear. Our previous work suggests that tympanic membrane assembly to the stapes head type prostheses performed best under low tension. This had not been previously tested for malleus assembly to the stapes head type prostheses. METHODS: Hydroxyapatite prostheses were used to reconstruct a missing incus defect in a fresh cadaveric human ear model. Two types of prostheses were used, one from the stapes head to the malleus (malleus assembly to the stapes head), the other from the stapes head to the tympanic membrane (tympanic membrane assembly to the stapes head). Stapes footplate center responses were measured using a laser Doppler vibrometer in response to calibrated acoustic frequency sweeps. RESULTS: Tension had a very significant effect on both types of prostheses in the lower frequencies. Loose tension was best overall. The malleus assembly to the stapes head type prostheses consistently performed better than the tympanic membrane assembly to the stapes head type prostheses when stratified for tension. CONCLUSION: Tension has a significant effect on prosthesis function. Malleus assembly to the stapes head type prostheses generally result in better transmission of vibrations to the stapes footplate than tympanic membrane assembly to the stapes head type prostheses.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".