Biological and Physicochemical Assessment of Middle Ear Prosthesis

Biocompatible Materials in Otorhinolaryngology and Their Antibacterial Properties

For decades, biomaterials have been commonly used in medicine for the replacement of human body tissue, precise drug-delivery systems, or as parts of medical devices that are essential for some treatment methods. Due to rapid progress in the field of new materials, updates on the state of knowledge about biomaterials are frequently needed. This article describes the clinical application of different types of biomaterials in the field of otorhinolaryngology, i.e., head and neck surgery, focusing on their antimicrobial properties. The variety of their applications includes cochlear implants, middle ear prostheses, voice prostheses, materials for osteosynthesis, and nasal packing after nasal/paranasal sinuses surgery. Ceramics, such as as hydroxyapatite, zirconia, or metals and metal alloys, still have applications in the head and neck region. Tissue engineering scaffolds and drug-eluting materials, such as polymers and polymer-based composites, are becoming more common. The restoration of life tissue and the ability to prevent microbial colonization should be taken into consideration when designing the materials to be used for implant production. The authors of this paper have reviewed publications available in PubMed from the last five years about the recent progress in this topic but also establish the state of knowledge of the most common application of biomaterials over the last few decades.

Thermoplastic Polymers with Nanosilver Addition-Microstructural, Surface and Mechanical Evaluation during a 36-Month Deionized Water Incubation Period

Three types of thermoplastic polymers, acrylonitrile butadiene styrene (ABS), polymethyl methacrylate acrylic (PMMA) and high-density polyethylene (HDPE), were enriched with silver nanoparticles (AgNPs) of 0.5 wt.% and 1.0 wt.%, respectively. The polymers and the composites were manufactured via injection molding. Regarding the potential of these polymers as matrices for long-term use as biomaterials, the aim of this study was to examine their stability in the in vitro conditions during a three-year incubation period in deionized water. In this work, microstructural observations were performed, and mechanical properties were assessed. Surface parameters, such as roughness and contact angle, were comprehensively investigated. The microstructural evaluation showed that the silver additive was homogeneously dispersed in all the examined matrices. The 36-month immersion period indicated no microstructural changes and proved the composites’ stability. The mechanical tests confirmed that the composites retained comparable mechanical properties after the silver incorporation. The Young’s modulus and tensile strength increased during long-term incubation. The addition of silver nanoparticles did not alter the composites’ roughness. The contact angle increased with the rising AgNP content. It was also shown that the materials’ roughness increased with the incubation time, especially for the ABS- and HDPE-based materials. The water environment conditions improved the wettability of the tested materials. However, the silver nanoparticles’ content resulted in the contact angle decreasing during incubation. The conducted studies confirmed that the mechanical properties of all the polymers and composites did not deteriorate; thus, the materials may be considered stable and applicable for long-term working periods in aqueous environments.

Antibacterial composite hybrid coatings of veterinary medical implants

The aim of the work was to develop innovative antibacterial hybrid coatings applied on implants that are used for anastomoses of animals' long bones and to assess their physicochemical and biological properties. Plates made of the titanium alloy were covered with composite hybrid layers so as to protect the implant surface against corrosion and to enhance it with antibacterial properties.The hybrid coatings were obtained electrochemical oxidation and sol-gel. First, a layer of titanium nanotubes was applied to the implants surface through anodization. Next, the sol-gel method was used to create the second layer with silver nanoparticles. The microstructure examination of the materials was performed with the SEM. The phase composition analysis was carried out via the X-ray diffraction. The surface parameters (roughness, contact angle and free surface energy) were assessed. Biological studies of implants were conducted, including the analysis of degradation processes, cell response and bactericidal activity. The results confirmed that the hybrid antibacterial layers effectively protected the implant surface against scratches and corrosion and eliminated bacteria, which in turn would promote bone healing. The advantageous physicochemical and biological properties of metallic implants with hybrid composite layers raise hopes for their applicability in the veterinary treatment of bone fractures.

De novo topology optimization of total ossicular replacement prostheses

Conductive hearing loss, due to middle ear pathologies or traumas, affects more than 5% of the population worldwide. Passive prostheses to replace the ossicular chain mainly rely on piston-like titanium and/or hydroxyapatite devices, which in the long term suffer from extrusion. Although the basic shape of such devices always consists of a base for contact with the eardrum and a stem to have mechanical connection with the residual bony structures, a plethora of topologies have been proposed, mainly to help surgical positioning. In this work, we optimize the topology of a total ossicular replacement prosthesis, by maximizing the global stiffness and under the smallest possible volume constraint that ensures material continuity. This investigation optimizes the prosthesis topology in response to static displacement loads with amplitudes that normally occur during sound stimulation in a frequency range between 100 Hz and 10 kHz. Following earlier studies, we discuss how the presence and arrangement of holes on the surface of the prosthesis plate in contact with the umbo affect the overall geometry. Finally, we validate the designs through a finite-element model, in which we assess the prosthesis performance upon dynamic sound pressure loads by considering four different constitutive materials: titanium, cortical bone, silk, and collagen/hydroxyapatite. The results show that the selected prostheses present, almost independently of their constitutive material, a vibroacustic behavior close to that of the native ossicular chain, with a slight almost constant positive shift that reaches a maximum of ≈5 dB close to 1 kHz. This work represents a reference for the development of a new generation of middle ear prostheses with non-conventional topologies for fabrication via additive manufacturing technologies or ultraprecision machining in order to create patient-specific devices to recover from conductive hearing loss.

Opportunities and challenging issues of nanomaterials in otological fields: an occupational health perspective

Nanotechnology may offer innovative solutions to overcome the physiological and anatomical barriers that make the diagnosis and treatment of ear diseases an extremely challenging issue. However, despite the solutions provided by nano-applications, the still little-known toxicological behavior of nanomaterials raised scientific concerns regarding their biosafety for treated patients and exposed workers. Therefore, this review provides an overview on recent developments and upcoming opportunities in nanoscale otological applications, and critically assesses possible adverse effects of nanosized compounds on ear structures and hearing functionality. Although such preliminary data do not allow to draw definite strategies for the evaluation of nanomaterial ototoxicity, they can still be useful to improve scientific community and workforce awareness regarding possible nanomaterial adverse effects on ear.