World’s First Middle Ear Transplant Done in South Africa with 3D Printing

In March 2019, Dr. Mashudu Tshifularo and his team at the University of Pretoria Faculty of Health carried out the world’s first middle ear transplant. The operation, which took place at the Steve Biko Academic Hospital in Pretoria, South Africa, used 3D printing to replace the bones of the middle ear, including the hammer, anvil, stirrup and ossicles.

“This innovation, the solution for hearing loss, comes as the first in the world, which calls for celebration,” Dr. Gwendoline Malegwale Ramokgopa, Gauteng Province Member of the Executive Committee for Health, told IOL. “We are here to congratulate Professor Tshifularo and the team.”

Damage to the middle ear is generally caused by birth defects, trauma, infections or metabolic disease. According to SABC News, experts believe that this procedure may be the answer to conductive hearing loss. Dr. Tshifularo’s methods can also be used to facilitate the reconstruction of the ossicles, the smallest bones in the human body, for middle ear procedures such as ossiculoplasty and stapedectomy to limit intrusion trauma.

“By replacing only the ossicles that aren’t functioning properly, the procedure carries significantly less risk than known prostheses and their associated surgical procedures,” Dr. Tshifularo, head of the Department of Otorhinolaryngology at the University of Pretoria, explained in a press release by the South African government.

Dr. Tshifularo used titanium during the procedure and an endoscope to carry out the replacement, resulting in a quick operation with minimal scaring. The operation also reduces the chance of facial nerve paralysis that may result during traditional surgical procedures, as the facial nerve passes through the middle ear.

This groundbreaking procedure was carried out on a man who damaged his middle ear in an injury. However, the surgery can even be performed on newborns.

Dr. Tshifularo believes that academics need to benefit the well-being of their communities through their teaching, research and clinical procedures and devices. He said that 3D technology is opening up new clinical methods that were never possible before.

“It’s a new technology, a new development which can be used in any patient,” Dr. Tshifularo explained. “Sometimes, if we take a CT scan or X-ray of your brain, we can see the bones that are broken or damaged and recreate them exactly as they are. So it will help a lot and it will be affordable.”

In 1967, Dr. Chris Barnard performed the world’s first human-to-human heart transplant in Cape Town. Dr. Tshifularo is proud to join the ranks of South African surgical pioneers, setting a precedent for the rest of the world.

“I think the main basis is that we are excited that is the pioneering is the first in the world, so even if the rest of the world will come, but they’ll always acknowledge that we started and we’ll always be two, three steps ahead of them,” he said.

 

The South African government plans to offer as much support as possible to Dr. Tshifularo and his team. South African Minister of Health Dr. Pakishe Aaron Motsoaledi is calling upon donors, development partners, and the South African business community to support the innovative technology.

“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 Dr. Motsoaledi.

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