Evidence map›Paper›PMID 41909994›Full record

ArticleThe Journal of laryngology and otology2026

Design and technical validation of a low-cost, titanium sheet metal TORP (SM-T) for manufacturing and use in LMICs.

Arjan J Knulst, Vivian van Asperen, Nabin Raj Gautam, Robert Geerts, Geert Ten Have, Sophia Hou, Alexandra Neuman, Michael Smith, Jenny Dankelman

Erratum issuedAbstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of laryngology and otology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Arjan J KnulstINF Green Pastures Hospital and Rehabilitation Center, International Nepal Fellowship, Nepal.ORCID https://orcid.org/0000-0002-3610-0877
Vivian van AsperenDepartment of Biomechanical Engineering, Delft University of Technologyhttps://ror.org/02e2c7k09, The Netherlands.
Nabin Raj GautamINF Green Pastures Hospital and Rehabilitation Center, International Nepal Fellowship, Nepal.
Robert GeertsDepartment of Biomechanical Engineering, Delft University of Technologyhttps://ror.org/02e2c7k09, The Netherlands.
Geert Ten HaveDepartment of Biomechanical Engineering, Delft University of Technologyhttps://ror.org/02e2c7k09, The Netherlands.
Sophia HouDepartment of Biomechanical Engineering, Delft University of Technologyhttps://ror.org/02e2c7k09, The Netherlands.
Alexandra NeumanDepartment of Biomechanical Engineering, Delft University of Technologyhttps://ror.org/02e2c7k09, The Netherlands.
Michael SmithINF Green Pastures Hospital and Rehabilitation Center, International Nepal Fellowship, Nepal.
Jenny DankelmanDepartment of Biomechanical Engineering, Delft University of Technologyhttps://ror.org/02e2c7k09, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTotal ossicular replacement prostheses are commonly used to restore hearing in the conductive hearing impaired. However, total ossicular replacement prostheses are expensive and scarcely available in low- and middle-income countries. Therefore, the aim was to develop and validate an open-source design of a total ossicular replacement prosthesis that can be produced locally for low- and middle-income countries hospitals.

methodsBased on input from literature and clinicians a design was made and verified. Accuracy, re-bending safety, cadaver ear fitting, sound transmission and production learning curves were tested.

resultsA titanium sheet metal total ossicular replacement prosthesis, costing 9 euro, showed accurate dimensions, surgeons showed short learning curves, and sound transmission was similar to commercial total ossicular replacement prostheses. Re-bending tests demonstrated bending corrections could be safely done. Good cadaver ear fitting could be demonstrated, without conflicts between the titanium sheet metal total ossicular replacement prosthesis and anatomical features.

conclusionThe titanium sheet metal total ossicular replacement prosthesis design has proved to be feasible for implementation in low- and middle-income countries.

Indexed as

Hearing Loss, ConductiveOssicular ProsthesisOssicular ReplacementProsthesis DesignTitaniumDeveloping CountriesHumansProsthesis FittingTitaniumearmiddleossicular prosthesisprintingprosthesis designthree-dimensional

Identifiers

PMID41909994
PMCPMC13443442

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.