Prof Mashudu “Tuks” Tshifularo, Head of the Department of Otorhinolaryngology at the University of Pretoria, South Africa, has gone down in history as the first surgeon to treat deafness using a middle-ear based surgical procedure [1]. This amazing breakthrough is expected to cure middle ear problems caused by congenital birth defects, infections, trauma or metabolic diseases. 

With his team of surgeons at the Steve Biko Academic hospital in S.A, Professor Tshifularo may have just consolidated a better long-term hearing approach than hearing aids and cochlear implants.

Quicker, safer, and less painful

On Wednesday, 13th March 2019, Professor Tuks performed a successful reconstructive surgery on a 35-year-old male patient whose middle ear structure was shattered in an accident.

The procedure was centered on replacing the damaged middle ear ossicles using 3D-printed bones.

The ossicles are three incredibly tiny bones found in the middle ear (the hammer, the anvil, the stirrup), which transmit sounds and vibrations from atmosphere to the inner ear [2]. Damaged ossicles will result in a loss of hearing, of which the severity will depend on the degree of damage incurred.

3D printing basically involves additive manufacturing, whereby a physical item is manufactured by placing ultra-thin layers of the intended structure upon one another [3]. The printer is instructed by a digital model of the object to be designed.

The amazing thing about this procedure is that it can be performed on anyone, ranging from newborns to aged adults.

“By replacing only the ossicles that aren’t functioning properly, the procedure carries significantly less risk than known prostheses and their associated surgical procedures,” says Prof Tshifularo to the South African Health Department, as quoted in a press release [4]. “We will use titanium for this procedure, which is biocompatible. We use an endoscope to do the replacement, so the transplant is expected to be quick, with minimal scarring.”

Titanium is recognized as the most biocompatible metal in existence, due to its high resistance to corrosion from bodily fluids, high fatigue limit, and bio-inertness [5].

Prof. Tuks emphasizes on affordability and accessibility

This new procedure has proven to be much safer than several others which have been tried out in the past. For starters, there’s reduced risk to facial nerve paralysis, which is one of the dangers of ear surgeries. The facial nerve that passes through the middle ear could get damaged during invasive procedures, resulting in the inability to move the face. Ossiculoplasty and stapedectomy are two traditional surgical procedures performed with the aim of reconstructing the middle-ear bone chain. Prof. Tshifularo’s procedure is likely to increase the success rates of these procedures with minimal intrusion trauma.

In an interview with to Jacaranda Fm, Prof. Tshifularo bemoans the need for the procedure to be easily accessible by the general public [6].

“Because we are doing it in the country and we are going to manufacture here, it has to be affordable for our people in state hospitals,” he explained. “It will be very accessible because as long as we can train the young doctors to be able to do this operation, then it will be accessible for them as well.”

Speaking on the first patient, he said, “This was one of our patients we have been waiting for, for this reconstruction for almost three years now because they are not affordable … [but] we have done something new in the world and people will remember us for that.”

In the press release, the South African Minister of Health, Aaron Motsoaledi, called on donors and development partners in the business community to support and invest in this new breakthrough.

As a Department of Health, we shall do everything in our power to assist and mobilize resources to make sure that Prof. Tshifularo gets all the help he needs for this far-reaching innovation”, said Minister Motsoaledi. 

References:

  1. South African Doctor Cures Deafness With First-Ever Middle Ear Transplant, The Mind Unleashed
  2. The Ossicles, Hyperphysics, Georgia State University
  3. What is 3D printing, 3dprinting.com
  4. Health on first world middle ear transplant done at Steve Biko Academic Hospital, South African Government
  5. Titanium biocompatibility, Wikipedia
  6. South Africa performs world’s first successful middle ear transplant, Jacarandafm
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