Telescoping self-adjusting ossicular prostheses

• US 4,601,723 A
• Filed: 01/29/1985
• Issued: 07/22/1986
• Est. Priority Date: 01/29/1985
• Status: Expired due to Fees

• Current Assignee: Robert N. Mcgrew
• Original Assignee: Robert N. Mcgrew
• Inventors: McGrew, Robert N.
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): Isabella, David J.
• Application Number:
  US06/695,835
• Time in Patent Office: 539 Days
• Field of Search: 403/104, 403/109, 403/70, 604/264, 128/334 R, 128/334 C, 128/1 R, 128/92 C, 3/1, 3/1.9
• US Class Current: 623/10
• CPC Class Codes: A61F 2/18 Internal ear or nose parts, e.g. ear-drums implants for middle ear ventilation or drainage A61F11/202
• CPC Class Codes: A61F 2002/183 Ear parts
• CPC Class Codes: A61F 2250/0007 for adjusting length

Abstract

Ossicular prostheses for total reconstructive surgery of an infection-destroyed or traumatically damaged middle ear. Each prosthesis comprises a pair of cooperating assemblies which are adapted to be extended between the tympanic membrane and the fenestra vestibuli (oval window) in replacement of the auditory ossicles, namely the malleus, incus, and stapes. In the best mode a first rigid, preferably stainless steel shaft is pivotally received by a flanged socket surgically secured to the ear drum. Flanged socket structure secured surgically to the oval window receives the balled end of an outwardly projecting, rigid, generally tubular shaft. The extreme end of the latter shaft is adapted to be axially mated with the first shaft which is coaxially, slidably telescoped thereto. In an alternative embodiment each of the two cooperating assemblies preferably comprises elongated shaft structure including twin, parallel, closely-spaced shaft members which originate from an integral loop-like base. The base portion of the first assembly is adapted to be sutured to at least a portion of the reconstructed tympanic membrane, and the base portion of the other shaft assembly is adapted to be secured with fascia in contact with the oval window. The elongated shafts are coupled together permitting length compensating, relative axial displacements. An extensible bridge is thus established in replacement of the middle ear ossicles by the installed prosthesis and variations in air pressure etc., experienced by the thus-repaired human ear are compensated for by pivotal and/or swivelling movement of the prosthesis and by relative axial displacements facilitated by the coupled shaft assemblies thereof.

Claims

1. A surgically implantable, length compensating auditory ossicular prosthesis for reconstruction of the ossicles of the middle ear, said prosthesis comprising:

an oval window assembly comprising;

elongated shaft means having a base portion adapted to be surgically coupled to to the oval window in pivotal relation therewith, and an integral, cooperating shaft portion extending outwardly from said base portion away from said oval window, said shaft portion comprising a pair of elongated, closely spaced, substantially parallel shaft members, each of said shaft members being integrally joined together in loop means forming said base portion, said loop means adapted to be sutured to at least a portion of said oval window permitting limited pivoting between said last mentioned shaft means and said oval window; and

,

a cooperating tympanic membrane assembly comprising;

elongated shaft means having a base portion adapted to be surgically coupled to at least a portion of the reconstructed or original tympanic membrane in pivotal relation therewith, and a cooperating shaft portion extending outwardly from said base portion away from said tympanic membrane;

said last mentioned shaft portion comprising a pair of elongated, closely spaced, substantially parallel shaft members, each of said last mentioned shaft members being integrally joined together in loop means forming said base portion of said last mentioned shaft means, said loop means adapted to be secured to at least a portion of said tympanic membrane permitting limited pivoting between said last mentioned shaft means and said tympanic membrane;

wherein said shaft portion of said oval window assembly is adapted to be frictionally, axially coupled to said shaft portion of said tympanic membrane assembly whereby to provide an axially extensible bridge between said oval window and said tympanic membrane capable of varying in length to accomodate variations in spacing between the oval window and the tympanic membrane with changes of air pressure.

2. The prosthesis as defined in claim 1 wherein:

the shaft members of said shaft means of said oval window assembly occupy a first plane;

the shaft members of said shaft means of said tympanic membrane assembly occupy a second plane; and

,

said first plane is substantially orthogonal with respect to said second plane, whereby said oval window shaft means may be axially, slidably coupled to said tympanic membrane shaft means.

3. A surgically implantable, length compensating, auditory ossicular prosthesis for reconstruction of the ossicles of the middle ear, said prosthesis comprising:

an oval window assembly comprising elongated shaft means having a base portion adapted to be surgically coupled to the oval window in pivotal relation therewith, and a cooperating shaft portion extending outwardly from said base portion away from said oval window, wherein the shaft means associated with said oval window assembly comprises a pair of elongated, closely spaced, substantially parallel shaft members, each of said shaft members being integrally joined together in loop means forming said base portion of said last mentioned shaft means, said loop means adapted to be sutured to at least a portion of said oval window permitting limited pivoting between said last mentioned shaft means and said oval window;

a cooperating tympanic membrane assembly comprising elongated shaft means having a base portion adapted to be surgically coupled to at least a portion of the reconstructed or original tympanic membrane in pivotal relation therewith, and a cooperating shaft portion extending inwardly from said base portion away from said tympanic membrane;

wherein the shaft means associated with said tympanic membrane assembly comprises a pair of elongated, closely spaced, substantially parallel shaft members, each of said last mentioned shaft members being integrally joined together in loop means forming said base portion, said loop means adapted to permit limited pivoting between said last mentioned shaft means and said tympanic membrane; and

,

wherein said shaft portion of said oval window assembly is adapted to be frictionally, axially coupled to said shaft portion of said tympanic membrane assembly whereby to provide an axially extensible bridge between said oval window and said tympanic membrane capable of varying in length to accomodate variations in spacing between the oval window and the tympanic membrane.

4. The prosthesis as defined in claim 3 wherein:

the shaft members of said shaft means of said oval window assembly occupy a first plane;

the shaft members of said shaft means of said tympanic membrane assembly occupy a second plane; and

,

said first plane is substantially orthogonal with respect to said second plane, whereby said oval window shaft means may be axially, slidably coupled to said tympanic membrane shaft means.

5. A surgically implantable, length compensating auditory ossicular prosthesis for reconstruction of the ossicles of the middle ear, said prosthesis comprising:

an oval window assembly comprising elongated shaft means having a base portion adapted to be surgically coupled to the oval window in pivotal relation therewith;

a cooperating shaft portion extending outwardly from said base portion away from said oval window; and

, first flanged anchor means adapted to be surgically coupled to the oval window;

wherein said first flanged anchor means includes integral socket means and a plurality of apertures for facilitating subsequent tissue ingrowth, and said base portion of said oval window means shaft means terminates in first ball means adapted to be coupled to said socket means to permit limited swiveling of said last mentioned shaft means with respect to said last mentioned anchor means;

a cooperating tympanic membrane assembly comprising elongated shaft means having a base portion adapted to be surgically coupled to at least a portion of the reconstructed or original tympanic membrane in pivotal relation therewith;

a cooperating shaft portion extending inwardly from said base portion away from said tympanic membrane; and

second flanged anchor means adapted to be surgically secured to at least a portion of the tympanic membrane, said last mentioned flanged anchor means including integral socket means and a plurality of apertures for facilitating subsequent tissue ingrowth;

wherein said tympanic membrane assembly shaft means base portion terminates in second ball means adapted to be coupled to said last mentioned socket means whereby to permit relative swiveling of said last mentioned shaft means with respect to said last mentioned anchor means; and

,

one of said shaft means of said tympanic membrane and oval window assemblies being tubular and the other one of said shaft means being generally cylindrical, wherein said shaft means of said tympanic membrane assembly may be telescopingly coupled to said shaft means of said oval window assembly whereby to provide an axially extensible bridge between said oval window and said tympanic membrane capable of varying in length to accomodate variations in spacing between the oval window and the tympanic membrane.

6. The prosthesis as defined in claim 5 wherein the shaft means of said tympanic membrane assembly is cylindrical and the shaft means of said oval window assembly is tubular and of a larger diameter whereby, after implantation of the two assemblies, they may be easily fitted together by centering the tympanic membrane assembly shaft relative to the exposed oval window assembly tubular shaft and thereafter frictionally forcing them together.