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SA makes medical history - again

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For years, 3D printing has been touted as the solution for everything from construction challenges to manufacturing bottlenecks, but has remained a specialist solution for very specific applications. Professor Mashudu Tshifularo and his team from the University of Pretoria have made use of the specialist nature and innate capabilities of 3D printing to perform the world’s first middle ear transplant.

SA makes medical history againEffectively replacing the hammer, anvil, and stirrup – the ossicles that make up the middle ear – using 3D-printed bones, Professor Tshifularo’s procedure carries significantly less risk than known prostheses and their associated surgical procedures. The bones were printed in titanium because it is a biocompatible material.

The surgery, which can be performed on anyone, even newborns, has already helped two patients. According to Prof. Tshifularo, the patients got their hearing back immediately, but because they were wrapped in bandages, it took two weeks (when the bandages were removed) for them to tell the difference in their hearing.

Following the ground-breaking procedure, the Professor told media that the hip replacement inspired him. “The innovation in this idea is to get the same size of the bone, position, shape, weight and length and put it exactly where it needs to be – almost like a hip replacement,” he said. Each patient’s bones were scanned and printed individually in order to ensure that minute individual differences were included to ensure a higher success rate for the procedure.

“3D technology is allowing us to do things we never thought we could, but I need sponsors and funding for this invention to take off the ground,” Prof. Tshifularo said. He wants to make this an affordable procedure, accessible to all South Africans.

The Department of Health is on board, with Health Minister Aaron Motsoaledi calling on donors and developers to support this breakthrough. “As the Department of Health, we shall do everything in our power to assist and mobilise resources to make sure that Professor Tshifularo gets all the help he needs for this far reaching innovation,” Motsoaledi said in an interview.

The transplant procedure is quick, with minimal scarring because it uses an endoscope to do the replacement. The procedure reduces the chance of facial nerve paralysis, which can occur if the facial nerve that passes through the middle ear space is damaged during traditional surgery. According to Prof. Tshifularo, this may be the answer to conductive hearing loss from middle ear problems caused by congenital birth defects, infection, trauma or metabolic diseases.

The fact that both surgeries using the new procedure were successful certainly points to its efficacy as a solution to hearing loss, and will hopefully be adopted by ear, nose and throat specialists around the world. Much like Chris Barnard’s pioneering heart transplant in the 60’s, Prof. Tshifularo’s procedure looks set to change the course of medical history, opening the door to more uses of 3D printing for bone replacements in the future.

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