Mail on Sunday; Health
2 September 2012, By Eifion Rees
Design technology used in Formula 1 racing has created an unlikely remedy for damaged eardrums.
The procedure uses a tiny graft of flesh taken from behind the ear to create an exact replica of the eardrum.
Although the operation has been done since the Seventies, surgeons always struggled to make the new eardrum mimic the shape of the real thing.
But by using a design technique that creates aerodynamic parts for racing cars, engineers have managed to build the perfect mould for an eardrum.
For sufferers such as Marion Pentney, this innovative procedure – called fasciaform tympanoplasty – has ended years of pain.
Marion, a healthcare assistant and mother of three from Freethorpe, Norfolk, developed hearing problems in 2004 after beginning a course of injections for rheumatoid arthritis.
An allergic reaction caused the skin on her body to peel, affecting both eardrums.
Marion, 50, was totally deaf for two months before her right ear healed. The left never did.
‘It was like having a nagging toothache I couldn’t get rid of,’ she says. ‘My doctors had got to the point where they didn’t know what to do with me.’
Then, in a move that changed Marion’s fate, consultant ENT surgeon John Phillips joined Norfolk and Norwich University Hospital after working in Canada under Rodney Perkins, the ear surgeon who first pioneered fasciaform tympanoplasty to create a perfect eardrum mould.
Until then, surgeons would simply try to create the eardrum’s bowl shape by squishing the tissue graft around the end of their finger. Rarely did this successfully recreate the corrugated, dustbin-lid-like surface that allows it to attach snugly to the inner ear.
Mr Phillips decided to try the operation in Britain. All he needed to do was create his own eardrum moulds. He sent plaster-of-Paris casts of the moulds used in Canada to Swansea-based medical instrument manufacturers DTR Medical.
Although the operation has been done since the Seventies, surgeons always struggled to make the new eardrum mimic the shape of the real thing
They worked with engineers at Cardiff University’s manufacturing engineering centre, using state-of-the-art design technology employed in F1 racing to make light, aerodynamic and individualised components for cars.
The technology is known as laser sintering: computer-scanning the casts in 3D, then building them in paper-fine layers of stainless steel to create a solid mould.
During the two-hour implantation operation, carried out under general anaesthetic, a thin disc of fibrous tissue is taken from beneath the skin behind the ear and pressed on to the eardrum mould. This is then dipped into formaldehyde to fix its shape. A small hole is made at the base.
The surgeon then removes the old eardrum and inserts the new one, hooking the hole on to the first bone of hearing, which runs from the centre of the eardrum to the roof of the ear canal. This makes the entire unit vibrate, which improves hearing.
Patients must wear a bandage for 24 hours after the operation, then wadding in the ear for the next fortnight.
Marion is one of only three UK patients to have undergone the fasciaform tympanoplasty using the new moulds and is in no doubt about the difference they have made to her life.
Even before her dressing came off, she knew her hearing was better than it had been for years.
‘I used to have the television turned up so loud, but now I’m turning it down all the time,’ she says. ‘I no longer have any infections or pain, or have to take antibiotics. That was the main thing – I never expected to get my hearing back again.’
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