Prestrain in the rabbit eardrum measured by digital image correlation and micro-incisions

The importance of mechanical and biological cues of tympanic membrane grafts to ensure optimal regeneration

Chronic suppurative otitis media (CSOM) is often associated with permanent tympanic membrane (TM) perforation and conductive hearing loss. The current clinical gold standard, using autografts and allografts, suffers from several drawbacks. Artificial replacement materials can help to overcome these drawbacks. Therefore, scaffolds fabricated through digital light processing (DLP) were herein created to support TM regeneration. Various UV-curable printing inks, including gelatin methacryloyl (GelMA), gelatin-norbornene-norbornene (GelNBNB) (crosslinked with thiolated gelatin (GelSH)) and alkene-functionalized poly-ε-caprolactone (E-PCL) (crosslinked with pentaerythritol tetrakis(3-mercaptopropionate) (PETA4SH)) were optimized regarding photo-initiator (PI) and photo-absorber (PA) concentrations through viscosity characterization, photo-rheology and the establishment of working curves for DLP. Our material platform enabled the development of constructs with a range of mechanical properties (plateau storage modulus varying between 15 and 119 kPa). Excellent network connectivity for the GelNBNB and E-PCL constructs was demonstrated (gel fractions >95 %) whereas a post-crosslinking step was required for the GelMA constructs. All samples showed excellent biocompatibility (viability >93 % and metabolic activity >88 %). Finally, in vivo and ex vivo assessments, including histology, vibration and deformation responses measured through laser doppler vibrometry and digital image correlation respectively, were performed to investigate the effects of the scaffolds on the anatomical and physiological regeneration of acute TM perforations in rabbits. The data showed that the most efficient healing with the best functional quality was obtained when both mechanical (obtained with the PCL-based resin) and biological (obtained with the gelatin-based resins) material properties were taken into account.

Prestrain in the eardrum investigated using laser-ablation perforation: A proof of principle study on the New Zealand white rabbit

While the presence of residual stress (also called prestress) in the tympanic membrane (TM) was hypothesized more than 150 years ago by von Helmholtz (1869), little experimental data exists to date. In this paper, a novel approach to study residual stress is presented. Using a pulsed laser, the New Zealand white rabbit TM is perforated at seven predefined locations. The subsequent retraction of the membrane around the holes is computed using digital image correlation (DIC). The amount of retraction is the so-called prestrain, which is caused by the release of prestress due to the perforation. By measuring the prestrain using DIC, we show that residual stress is clearly present over the entire rabbit TM surface. In total, fourteen TMs have been measured in this work. An automated approach allows tracking the holes' deformation during the measurement process and enables a more robust analysis than was previously possible. We find similar strains (around 5%) as reported in previous work, in which slits were created manually using flattened surgical needles. However, the new approach greatly reduces measurement time, which minimizes dehydration artifacts. To investigate the effect of perforation location on the TM, the spatial decrease of the prestrain (α) around the perforation was quantified. Perforations inferior to the umbo showed the least negative α values, i.e., the most gradual decrease around the hole, and were the most consistent. Perforations on other locations showed more negative α values, i.e., steeper decrease in strain, but were less consistent across samples. We also investigated the effect of the holes' creation sequence but did not observe a significant change in the results. Overall, the presented method allows for consistent residual stress measurements over the TM surface. The findings contribute to our fundamental knowledge of the mechanics of the rabbit TM and provide a basis for future work on human TMs.

Rabbit tympanic membrane thickness distribution obtained via optical coherence tomography

Knowing the precise tympanic membrane (TM) thickness variation is crucial in understanding the functional properties of the TM and has a significant effect on the accuracy of computational models. Using optical coherence tomography, we imaged five left and five right TMs of domestic New Zealand rabbits. From these data, ten thickness distribution maps were computed. Although inter-specimen variability is present, similar features could be observed in all samples: The rabbit TM is thickest around the umbo, with values of 150 ± 32 µm. From the umbo towards the TM annulus, the thickness gradually decreases down to 38 ± 7 µm around the midway location, but increases up to 54 ± 19 µm at the TM annulus. The thickness values at the umbo are comparable to literature data for humans, but the rabbit TM is thinner at the TM annulus and in-between the umbo and annulus. Moreover, the rabbit TM thickness distribution is highly symmetrical, which is not the case for the human TM. The results improve our general understanding of TM structure in rabbits and may improve numerical models of TM dynamical behavior.

Benchtop characterization of the tricuspid valve leaflet pre-strains

The pre-strains of biological soft tissues are important when relating their in vitro and in vivo mechanical behaviors. In this study, we present the first-of-its-kind experimental characterization of the tricuspid valve leaflet pre-strains. We use 3D photogrammetry and the reproducing kernel method to calculate the pre-strains within the central 10×10 mm region of the tricuspid valve leaflets from n=8 porcine hearts. In agreement with previous pre-strain studies for heart valve leaflets, our results show that all the three tricuspid valve leaflets shrink after explant from the ex vivo heart. These calculated strains are leaflet-specific and the septal leaflet experiences the most compressive changes. Furthermore, the strains observed after dissection of the central 10×10 mm region of the leaflet are smaller than when the valve is explanted, suggesting that our computed pre-strains are mainly due to the release of in situ annulus and chordae connections. The leaflets are then mounted on a biaxial testing device and preconditioned using force-controlled equibiaxial loading. We show that the employed preconditioning protocol does not 100% restore the leaflet pre-strains as removed during tissue dissection, and future studies are warranted to explore alternative preconditioning methods. Finally, we compare the calculated biomechanically oriented metrics considering five stress-free reference configurations. Interestingly, the radial tissue stretches and material anisotropies are significantly smaller compared to the post-preconditioning configuration. Extensions of this work can further explore the role of this unique leaflet-specific leaflet pre-strains on in vivo valve behavior via high-fidelity in-silico models.