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Boillat M, Bonnet AS, Groubatch F, Falanga A, Gillet R, Parietti-Winkler C. Analysis of the milling response of an artificial temporal bone developed for otologic surgery in comparison with human cadaveric samples. Med Eng Phys 2024; 131:104220. [PMID: 39284647 DOI: 10.1016/j.medengphy.2024.104220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 07/18/2024] [Accepted: 07/31/2024] [Indexed: 09/19/2024]
Abstract
Temporal-bone milling is a delicate process commonly performed during otologic surgery to gain access to the middle and inner ear structures. Because of the numerous at-risk structures of this anatomic area, extensive surgeon training is required. Artificial temporal bones offer an interesting alternative to cadaveric training. However, the evaluation of such simulators has not been systematic, with an absence of objective validation of their milling response, especially in a surgical context. By measuring the milling forces obtained during the classical steps of otologic surgery on six 3D-printed and three cadaveric temporal bones, this work aims at evaluating the ability of the OTOtwin® synthetic temporal bone to reproduce human bone behavior. A better repeatability was obtained for artificial bones than for cadaveric ones. However, the level of forces recorded during artificial bone milling was close to the one measured with cadaveric samples. The effects of both surgical phase and irrigation on milling force levels were also quantified. The experiments conducted in this study confirmed the suitability of OTOtwin® temporal bone model for both otologic surgery training and research purposes. Valuable insights were also gained from this study regarding the understanding of the otologic milling process.
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Affiliation(s)
- Martin Boillat
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3 F-57000 Metz, France
| | - Anne-Sophie Bonnet
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3 F-57000 Metz, France.
| | - Frédérique Groubatch
- Université de Lorraine, Faculté de Médecine, 9 avenue de la Forêt de Haye 54500 Vandoeuvre-les-Nancy, France
| | - Aude Falanga
- Université de Lorraine, Faculté de Médecine, 9 avenue de la Forêt de Haye 54500 Vandoeuvre-les-Nancy, France
| | - Romain Gillet
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, 29 Avenue du Maréchal de Lattre de Tassigny F-54000 Nancy, France; Université de Lorraine, CHRU Nancy, INSERM, IADI F-54000 Nancy, France
| | - Cécile Parietti-Winkler
- Département d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, CHRU Nancy, France; Université de Lorraine, Ecole de Chirurgie Nancy-Lorraine, Faculté de Médecine de Nancy 54500 Vandœuvre-lès-Nancy, France
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Hearing loss drug discovery and medicinal chemistry: Current status, challenges, and opportunities. PROGRESS IN MEDICINAL CHEMISTRY 2022; 61:1-91. [PMID: 35753714 DOI: 10.1016/bs.pmch.2022.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Hearing loss is a severe high unmet need condition affecting more than 1.5 billion people globally. There are no licensed medicines for the prevention, treatment or restoration of hearing. Prosthetic devices, such as hearing aids and cochlear implants, do not restore natural hearing and users struggle with speech in the presence of background noise. Hearing loss drug discovery is immature, and small molecule approaches include repurposing existing drugs, combination therapeutics, late-stage discovery optimisation of known chemotypes for identified molecular targets of interest, phenotypic tissue screening and high-throughput cell-based screening. Hearing loss drug discovery requires the integration of specialist therapeutic area biology and otology clinical expertise. Small molecule drug discovery projects in the global clinical portfolio for hearing loss are here collated and reviewed. An overview is provided of human hearing, inner ear anatomy, inner ear delivery, types of hearing loss and hearing measurement. Small molecule experimental drugs in clinical development for hearing loss are reviewed, including their underpinning biology, discovery strategy and activities, medicinal chemistry, calculated physicochemical properties, pharmacokinetics and clinical trial status. SwissADME BOILED-Egg permeability modelling is applied to the molecules reviewed, and these results are considered. Non-small molecule hearing loss assets in clinical development are briefly noted in this review. Future opportunities in hearing loss drug discovery for human genomics and targeted protein degradation are highlighted.
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Tames HLVC, Padula M, Sarpi MO, Gomes RLE, Toyama C, Murakoshi RW, Olivetti BC, Gebrim EMMS. Postoperative Imaging of the Temporal Bone. Radiographics 2021; 41:858-875. [PMID: 33739892 DOI: 10.1148/rg.2021200126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The anatomy of the temporal bone is complex, and postoperative imaging evaluation of this bone can be challenging. Surgical approaches to the temporal bone can be categorized didactically into tympanoplasty and ossicular reconstruction, mastoidectomy, and approaches to the cerebellopontine angle and internal auditory canal (IAC). In clinical practice, different approaches can be combined for greater surgical exposure. Postoperative imaging may be required for follow-up of neoplastic lesions and to evaluate unexpected outcomes or complications of surgery. CT is the preferred modality for assessing the continuity of the reconstructed conductive mechanism, from the tympanic membrane to the oval window, with use of grafts or prostheses. It is also used to evaluate aeration of the tympanic and mastoid surgical cavities, as well as the integrity of the labyrinth, ossicular chain, and tegmen. MRI is excellent for evaluation of soft tissue. Use of a contrast-enhanced fat-suppressed MRI sequence is optimal for follow-up after IAC procedures. Non-echo-planar diffusion-weighted imaging is optimal for detection of residual or recurrent cholesteatoma. The expected imaging findings and complications of the most commonly performed surgeries involving the temporal bone are summarized in this review. Online supplemental material is available for this article. ©RSNA, 2021.
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Affiliation(s)
- Hugo L V C Tames
- From the Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 75, São Paulo, SP 05403-000, Brazil
| | - Mario Padula
- From the Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 75, São Paulo, SP 05403-000, Brazil
| | - Maíra O Sarpi
- From the Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 75, São Paulo, SP 05403-000, Brazil
| | - Regina L E Gomes
- From the Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 75, São Paulo, SP 05403-000, Brazil
| | - Carlos Toyama
- From the Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 75, São Paulo, SP 05403-000, Brazil
| | - Rodrigo W Murakoshi
- From the Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 75, São Paulo, SP 05403-000, Brazil
| | - Bruno C Olivetti
- From the Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 75, São Paulo, SP 05403-000, Brazil
| | - Eloísa M M S Gebrim
- From the Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 75, São Paulo, SP 05403-000, Brazil
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Panda A, Carlson ML, Diehn FE, Lane JI. Beyond Tympanomastoidectomy: A Review of Less Common Postoperative Temporal Bone CT Findings. AJNR Am J Neuroradiol 2021; 42:12-21. [PMID: 33184072 PMCID: PMC7814786 DOI: 10.3174/ajnr.a6802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/18/2020] [Indexed: 11/07/2022]
Abstract
Postoperative temporal bone imaging after surgical procedures such as ossiculoplasty, tympanomastoidectomy, cochlear implantation, and vestibular schwannoma resection is often encountered in clinical neuroradiology practice. Less common otologic procedures can present diagnostic dilemmas, particularly if access to prior operative reports is not possible. Lack of familiarity with the less common surgical procedures and expected postoperative changes may render radiologic interpretation challenging. This review illustrates key imaging findings after surgery for Ménière disease, superior semicircular canal dehiscence, temporal encephalocele repairs, internal auditory canal decompression, active middle ear implants, jugular bulb and sigmoid sinus dehiscence repair, and petrous apicectomy.
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Affiliation(s)
- A Panda
- From the Departments of Radiology (A.P., J.I.L., F.E.D.)
| | - M L Carlson
- Otolaryngology-Head and Neck Surgery (M.L.C.), Mayo Clinic, Rochester, Minnesota
| | - F E Diehn
- From the Departments of Radiology (A.P., J.I.L., F.E.D.)
| | - J I Lane
- From the Departments of Radiology (A.P., J.I.L., F.E.D.)
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