Ossicular prosthesis having a spring clip

Abstract

The invention relates to a partially annular fastening element (2) of an ossicular prosthesis (1) ("stapes prosthesis") for a human middle ear, which fastening element is provided in one piece with a window (6) which extends in a circumferential direction of the fastening element (2) and in which an arcuate spring clip (8) is arranged which is integral with the fastening element (2) and which projects in the shape of an arc with a gradient inwards beyond an inner circumference of the fastening element (2). The spring clip (8) which rests preloadedly against the ossicle causes the ossicular prosthesis (1) to be fitted on an ossicle without play.

Description

Ossicular prosthesis with spring tab

[0001] The invention relates to an auditory ossicular prosthesis having the features of the preamble of claim 1.

[0002] Ossicular prostheses serve as a replacement for one or more auditory ossicles in the human middle ear and transmit vibrations of the eardrum generated by sound waves to an existing auditory ossicle, usually to the stapes, or to the oval window, instead of the replaced auditory ossicle(s).

[0003] Patent application EP 2 926 771 A1 discloses an ossicular prosthesis with a partially ring-shaped fastening element that is placed on an ossicle in a human middle ear and compressed to secure the fastening element of the ossicular prosthesis to the ossicle. The ossicle is attached, for example, to the handle of the malleus or to the shank of the anvil in the middle ear. "Hammer" and "anvil" are synonymous with ossicular prosthesis. Alternatively, the fastening element of the known ossicular prosthesis can be placed on an actuator end piece of an active, vibration-generating hearing aid that has been inserted into the human middle ear. One problem with this is that the fastening element of the ossicular prosthesis springs back slightly after being compressed due to unavoidable elasticity, which can make the fastening element unsafe on the respective ossicle.

[0004] A prosthetic body in the shape of a shaft protrudes radially from the partially ring-shaped attachment element of the known ossicular prosthesis. This prosthetic body, for example, is guided through an opening in the footplate of a stapes in the human middle ear and extends freely into the inner ear to transmit and release sound vibrations to the inner ear. "Stespes" refers to the auditory ossicle.

[0005] To avoid the problem of loosening, patent US 6,554,861 B2 proposes manufacturing the fastening element from a biocompatible nickel-titanium alloy known as NiTinol or another biocompatible shape memory material and, after placing it on the ossicle, heating it with a laser or other heat source, utilizing the shape memory effect and, in a sense, shrinking the fastening element onto the ossicle.

[0006] As an alternative, patent EP 1 745 762 B1 proposes a double-walled, partially ring-shaped fastening element for an ossicular prosthesis, with a radially resilient outer partial ring and a likewise radially resilient inner partial ring. The partial rings are not pressed onto the ossicle, but rather simply clipped on. The fastening element of these ossicles is held on the ossicle solely by the spring force of its partial rings.

[0007] The object of the invention is to propose an ossicular prosthesis of the type described above, which has a partially ring-shaped fastening element which has a good and, if possible, play-free fit on an ossicle in a human middle ear.

[0008] This object is achieved according to the invention by the features of claim 1. Advantageous further developments are in the dependent claims.

[0009] The auditory ossicle prosthesis according to the invention comprises a fastening element in the shape of a ring open in a peripheral section, which can also be considered a partial ring. The fastening element can, but does not have to, be circular; it can also be round and / or have corners. The open or missing peripheral section of the fastening element forms an opening for placing the fastening element on an auditory ossicle in a human middle ear.

[0010] The fastening element is attached to the auditory ossicle, for example, like a clip. In particular, the fastening element is placed on the handle of a hammer or on the shank of an anvil in the middle ear, where "hammer" and "anvil" refer to auditory ossicles. Alternatively, the fastening element of the auditory ossicle prosthesis according to the invention can be placed on an actuator end piece of an active, vibration-generating sound transducer of a middle ear implant that has previously been inserted into the human middle ear.

[0011] The fastening element of the ossicular prosthesis according to the invention extends over more than 180° in a circumferential direction so that it is held on the ossicle not only by force / frictional engagement, but also by positive engagement in the radial direction. In particular, the fastening element extends over approximately 200° to 245° in the circumferential direction.

[0012] According to the invention, the fastening element has a recess that is open on an inner circumference of the fastening element. A spring element is arranged in the recess, which protrudes inward from the fastening element beyond the inner circumference of the fastening element. A recess in the sense of this invention also includes an opening that extends from the inner circumference to the outer circumference, or a partial or continuous incision of the circumferential end face so that the cross-sectional area of ​​the fastener is tapered.

[0013] The ossicular prosthesis is placed with its fastening element on an ossicle in the human middle ear and, if necessary, compressed or pressed against the ossicle, whereby the fastening element is plastically deformed. By placing the fastening element on the ossicle, or at the latest by compressing it with plastic deformation of the fastening element, the spring element is preloaded and rests against the ossicle with a preload. This ensures that the fastening element rests on the ossicle without play. The spring element compensates for any elastic expansion of the fastening element after it has been compressed against the ossicle.

[0014] Alternatively, the ossicular prosthesis according to the invention can be placed, as described, onto the actuator end piece of the active, vibration-generating sound transducer of a middle ear implant and, if necessary, compressed. In this case, the fastening element also rests on the sound transducer without play, thereby reducing distortion or attenuation of sound transmission to the ossicular prosthesis.

[0015] The recess can also be open along an outer periphery of the fastening element, i.e., for example, formed as a window in the fastening element. However, the recess can also be open toward one of the peripheral end faces of the fastening element, whereby this recess can be open or closed to the outer periphery of the fastening element. In this case, the cross-sectional area of ​​the fastening element is reduced at the location of the recess.

[0016] In particular, a shaft or other prosthetic body protrudes radially, parallel to a radial, or in another direction from the fastening element of the ossicular prosthesis according to the invention. The shaft or other prosthetic body serves as a sound-conducting connection from the fastening element, for example, An opening in the footplate of the stapes in the human middle ear extends freely into the inner ear to transmit and release sound vibrations to the inner ear. The ossicular prosthesis according to the invention can thus transmit vibrations from an eardrum or a sound transducer of a middle ear implant to the inner ear. This could also occur via the round window or a specially surgically created opening in the inner ear.

[0017] The dependent claims relate to advantageous embodiments and further developments of the invention.

[0018] A further development of the invention provides two or more spring elements that are arranged offset from one another in a circumferential direction of the fastening element and / or parallel in one or more recesses open on the inner circumference of the fastening element and project inward beyond the inner circumference of the fastening element. The spring elements can be distributed evenly or unevenly over the circumference of the fastening element.

[0019] The fastening element is preferably plastically deformable in order to be able to press it against the auditory ossicle, wherein the spring element(s) is / are elastically pressed against the auditory ossicle with a pre-tension or a pre-tension with which the spring element(s) press against the auditory ossicle is / are increased.

[0020] In an optional embodiment, the spring element(s) or spring tab(s) can have one or more markings suitable for visually determining the preload. For example, a marking can be applied to a side wall of the spring element. If preload is applied, the spring element is elastically deformed relative to the fastening element, which can then be easily determined visually when viewed from the side using the marking. If a scale is used as a marking, even the degree of preload can be read. This advantageously enables the fit of the inventive appropriate ossicular prosthesis, can be easily visually inspected during the surgical procedure.

[0021] One embodiment of the invention provides for the spring element to be designed as a spring tab that springs radially relative to the fastening element in the manner of an arcuate leaf spring clamped on one or both sides. The spring tab is arcuate, in particular, with the same or a similar curvature as the fastening element in a circumferential section in which the spring tab is arranged. The spring tab is arranged in the recess open on the inner circumference of the fastening element of the auditory ossicular prosthesis according to the invention and has a gradient with respect to the inner circumference of the fastening element, which means that the spring tab runs at an acute angle to the inner circumference of the fastening element such that the spring tab projects inward beyond the inner circumference of the fastening element.In this case, the projection of the spring tab relative to the inner circumference of the fastening element increases inwards in a circumferential direction, whereby the projection can also decrease again over a length of the spring tab in the circumferential direction of the fastening element. As a result, the spring tab projects furthest inwards beyond the inner circumference of the fastening element at a circumferential point or in a circumferential section of the fastening element. The circumferential point or the circumferential section at which the spring tab projects furthest inwards beyond the inner circumference of the fastening element is preferably located at a circumferential end of the spring tab, but can also be located in a central circumferential section or in any case in a circumferential section of the spring tab that does not adjoin a circumferential end of the spring tab.

[0022] One embodiment of the invention provides that the fastening element of the auditory ossicle prosthesis has a partially annular strip that is open in one circumferential section, such that the opening for placing the fastening element on the auditory ossicle is formed. The fastening element or strip does not have to be circular, as described, but can also be round and / or have corners. The strip has a window, i.e., an opening extending from the inner circumference to the outer circumference, which forms the recess of the fastening element that is open on the inner circumference. The spring element is, as described As explained above, it is designed as a spring tab that is resilient radially relative to the fastening element and is arranged in the window in such a way that the spring tab projects inwards beyond the inner circumference of the fastening element.

[0023] In a further development of the invention, one circumferential end of the spring tab merges integrally into the fastening element. Another circumferential end of the spring tab is free, i.e., can move radially relative to the fastening element through elastic bending of the spring tab. In this embodiment of the invention, the spring tab corresponds to an arcuate leaf spring clamped at one end. In embodiments of the invention, both circumferential ends of the spring tab can also merge integrally into the fastening element, similar to an arcuate leaf spring clamped at both ends. In the latter case, the spring element projects inward between its circumferential ends beyond the inner circumference of the fastening element.

[0024] Preferably, the spring element and the fastening element are integral. For example, the fastening element is designed as a stamped and bent sheet metal part or as a bent part with a laser-cut spring element. For example, the spring tab(s) and the window forming the recess are produced, for example, in an initially flat, elastically and plastically bendable strip by punching, laser cutting, or some other method. The strip is then bent to form the partial ring, and the spring tab is bent to protrude more inward beyond the inner circumference of the fastening element.

[0025] All features mentioned in the description and / or illustrated in the drawings can be implemented individually or in any combination in embodiments of the invention. Embodiments of the invention that include only a portion of the features of a claim, including the independent claim, are possible.

[0026] The invention is explained in more detail below with reference to three exemplary embodiments shown in the drawings. They show:

[0027] Figure 1A is a side view of an ossicular prosthesis according to the invention with Viewing direction axial to a fastening element;

[0028] Figure 1B is a perspective view of the ossicular prosthesis of Figure 1A;

[0029] Figure 2 is a perspective view of a second embodiment of an ossicular prosthesis according to the invention;

[0030] Figure 3A is a side view of a third embodiment of an inventive Ossicular prosthesis viewed axially to a fixation element;

[0031] Figure 3B is a perspective view of the ossicular prosthesis of Figure 3A;

[0032] Figure 4A is a side view of a fourth embodiment of an ossicular prosthesis according to the invention, viewed axially to a fastening element;

[0033] Figure 4B is a perspective view of the ossicular prosthesis from Figure 4A;

[0034] Figure 5A is a side view of a fifth embodiment of an ossicular prosthesis according to the invention, viewed axially to a fastening element;

[0035] Figure 5B is a perspective view of the ossicular prosthesis from Figure 8;

[0036] Figure 6A is a side view of a sixth embodiment of an auditory ossicle prosthesis according to the invention, viewed axially to a fastening element; and

[0037] Figure 6B is a perspective view of the ossicular prosthesis of Figure 6A.

[0038] In principle, identical parts in the figures are provided with identical reference numbers.

[0039] The auditory ossicle prosthesis 1 according to the invention, shown in Figures 1A and 1B, is a so-called stapes prosthesis, which is intended for replacing one or more auditory ossicles (not shown) in a human middle ear. The auditory ossicle prosthesis 1 has a fastening element 2 and a shaft 3 that protrudes outwardly—in the exemplary embodiment, radially—from the fastening element 2 and can generally also be considered a prosthesis body.

[0040] The fastening element 2 is intended for attachment to an auditory ossicle in the human middle ear. For example, the fastening element 2 is attached to a malleus of a hammer or to a long or short limb of an anvil, where "hammer" and "anvil" refer to two of the three auditory ossicles in the human middle ear.

[0041] The stem 3 is inserted, for example, into a previously created perforation in the footplate of a stapes, where "stapes" also refers to an auditory ossicle in the human middle ear. In this way, the ossicular prosthesis 1 makes it possible to transmit vibrations from the anvil or malleus via the human middle ear to the inner ear.

[0042] Alternatively, the fastening element 2 of the auditory ossicular prosthesis 1 according to the invention can also be placed, for example, on an actuator end piece of an active, vibration-generating sound transducer of a middle ear implant that has been inserted into the human middle ear in order to transmit vibrations from the sound transducer via the shaft 3 to the inner ear (not shown).

[0043] In the exemplary embodiment, the fastening element 2 comprises a metal strip, for example made of pure titanium or a titanium alloy, which is bent into a partial circular ring, which in the exemplary embodiment extends over approximately 245° in a circumferential direction extends. A circumferential section of the partial circular ring that is missing to form a full ring forms an opening 4 for attaching the fastening element 2 in the manner of a clip onto the auditory ossicle (not shown). A partial circular ring shape is not mandatory for the fastening element 2 of the auditory ossicle prosthesis 1 according to the invention; the fastening element 2 can, for example, also have the shape of a non-circular, round and / or cornered partial ring, which has the opening 4 for attachment to the auditory ossicle (not shown).

[0044] The circumferential ends of the partial circular ring are bent outward at an angle to form insertion bevels 5. These facilitate the placement of the fastening element 2 on the auditory ossicle.

[0045] In the exemplary embodiment, the shaft 3 is arranged on one of the two insertion bevels 5, but can also protrude outwards from the fastening element 2 at another location (not shown).

[0046] The metal strip from which the fastening element 2 of the auditory ossicle prosthesis 1 according to the invention is bent in the exemplary embodiment has a rectangular cross-section, with a width of the metal strip extending axially parallel and a thickness extending radially to the fastening element 2. The width refers to a larger transverse dimension of the metal strip forming the fastening element 2, and the thickness refers to a smaller transverse dimension. This allows the partially annular fastening element 2 to spring radially to allow it to be placed on the auditory ossicle.

[0047] The fastening element 2 has a window 6, i.e., an opening extending from the outside to the inside, which extends over a large part of the circumference of the fastening element. The window 6 forms a recess 7, which is open on an inner circumference of the fastening element 2—and, in the exemplary embodiment, also on an outer circumference of the fastening element 2.

[0048] In the window 6 or in the recess 7 of the fastening element 2 of the auditory ossicle prosthesis 1 according to the invention, a strip-shaped spring tab 8 which can generally also be understood as a spring element 9 that is resilient radially relative to the fastening element 2. One circumferential end of the spring tab 8 merges integrally into the fastening element 2, while another circumferential end of the spring tab 8 is freely movable radially relative to the fastening element 2.

[0049] The spring tab 8 extends in an arcuate manner in the circumferential direction of the fastening element 2 and has a slightly smaller radius of curvature than the fastening element 2, such that the spring tab 8 has a gradient with respect to the inner circumference of the fastening element 2. This means that the spring tab 8 runs in a helical shape at an acute angle to the inner circumference of the fastening element 2 and projects inwards beyond the inner circumference of the fastening element 2. The inward projection of the spring tab 8 beyond the inner circumference of the fastening element 2 increases with increasing distance from the circumferential end of the spring tab 8, which is integral with the fastening element 2, to the free circumferential end, where the inward projection of the spring pocket 8 beyond the inner circumference of the fastening element 2 is greatest.

[0050] The spring tab 8 can optionally have a marking 12 on a side wall 11. If a preload is applied, the spring tab 8 is elastically deformed outwards relative to the fastening element 2, which can then be easily determined visually using the marking 12 when viewing the fastening element 2 from the side. Figure 1A shows an example of the ossicular prosthesis 1 according to the invention in a side view. The spring tab 8 is pressed outwards depending on the applied preload, and the greater the preload, the further it is pressed outwards, which can be easily determined from the position of the marking 12 relative to the fastening element 2 when viewed from the side. If a scale is used as a marking, the degree of preload can even be read off. Any form of marking that allows easy visual recognition can be used.To further simplify visual recognition, the marking can be provided with a high-contrast color, such as green. This optional embodiment of the spring tab 8 can be used in any embodiment of the auditory ossicular prosthesis 1 according to the invention and is by no means limited to the embodiment in Figures 1A and 1B. This advantageously enables the fit of the ossicular prosthesis 1 according to the invention can be easily visually inspected during the surgical procedure.

[0051] The window 6, which forms the recess 7 open on the inner circumference in the fastening element 2 of the ossicular prosthesis 1 according to the invention, and the spring tab 8, one end of which merges integrally into the fastening element 2, are manufactured by laser cutting in the exemplary embodiment, but can also be stamped or manufactured in another way. In the exemplary embodiment, the spring tab 8 forming the spring element 9 and the fastening element 2 of the ossicular prosthesis 1 according to the invention are made in one piece, although the invention does not preclude a multi-piece design.

[0052] The spring tab 8 forming the spring element 9 can be regarded as an arcuate leaf spring clamped on one side; it springs radially to the fastening element 2.

[0053] For attachment to the auditory ossicle (not shown), the fastening element 2 of the inventive auditory ossicle prosthesis 1 is placed and applied in the manner of a clip onto the auditory ossicle, for example, the malleus of the hammer or one of the two extensions of the anvil. Because the fastening element 2 is radially resilient, it can be placed or clipped on and, because it extends over more than 180° in the circumferential direction—in the exemplary embodiment, over approximately 245°—is held in place by capillary forces and / or additionally by frictional engagement on the auditory ossicle.

[0054] When applying the fastening element 2 to the auditory ossicle, the spring tab 8, which is radially resilient to the fastening element 2 and projects inwards beyond the inner circumference of the fastening element 2 and comes into contact with the auditory ossicle when placed on the auditory ossicle, is radially prestressed by the fastening element 2 being plastically deformed and resting against the auditory ossicle with a prestress, whereby the fastening element 2 is fixed to the auditory ossicle without play.

[0055] To do this, the fastening element 2 is compressed and pressed against the auditory ossicle, causing it to undergo plastic deformation. This increases the preload with which the spring tab 8 forming the spring element 9 rests against the auditory ossicle. If the fastening element 2 expands slightly again after being compressed, the spring tab 8 compensates for this, ensuring that the fastening element 2 rests against the auditory ossicle without any play.

[0056] Figure 2 shows that the spring tab 8 can also be oriented in reverse, i.e., in comparison with Figures 1A and 1B, the fixed and free circumferential ends of the spring tab 8 are swapped.

[0057] A further difference from Figures 1A and 1B is that the fastening element 2 of the auditory ossicular prosthesis 1 according to the invention shown in Figure 2 has two windows 6 offset in the circumferential direction of the fastening element 2 or open recesses 7 on the inner circumference of the fastening element, in each of which a spring tab 8 is arranged as a spring element 9. The windows 6 or recesses 7 and the spring tabs 8 are shorter in Figure 2 in the circumferential direction of the fastening element 2 than in Figures 1A and 1B. As in Figures 1A and 1B, the spring tabs 8 in Figure 2 merge into the fastening element 2 at one circumferential end and have a free circumferential end that is resilient radially to the fastening element 2 and projects inward beyond the inner circumference of the fastening element 2.The spring tabs 8 can be oriented identically or oppositely, meaning that the fixed and free circumferential ends of one or both spring tabs 8 can be interchanged compared to the drawing. The spring tabs 8 can have various suitable external shapes. For example, with a rectangular cross-section as shown in Figures 1A, 1B, and 2, a variable cross-section as shown in Figures 3A and 3B, or other suitable shapes.

[0058] Furthermore, the auditory ossicle prosthesis 1 according to the invention shown in Figure 2 is of the same design as the auditory ossicle prosthesis 1 shown in Figures 1A and 1B, so that in order to avoid repetition, reference can be made to the explanations of Figures 1A and 1B for the explanation of Figure 2.

[0059] Compared to Figure 2, the spring tabs 8 of the auditory ossicle prosthesis 1 according to the invention shown in Figures 3A and 3B have transverse webs 10 that protrude laterally from the spring tabs 8, i.e., in a direction parallel to the axis of the fastening element 2. The narrower spring tabs 8 increase the elasticity of the spring tabs 8, and the transverse webs 10 improve the support on the auditory ossicle (not shown) due to their greater width relative to the spring tabs 8.

[0060] In the exemplary embodiment, the transverse webs 10 protrude inwardly beyond the inner circumference of the spring tabs 8 in a tooth-like manner in order to improve the hold of the fastening element 2 on the auditory ossicle and to reduce the springing back of the fastening element 2. Designs of the auditory ossicle prosthesis 1 in which the transverse webs 10 do not protrude inwardly but are flush with the spring tabs 8 on the inner circumference are possible.

[0061] Furthermore, the auditory ossicle prosthesis 1 according to the invention shown in Figures 3A and 3B is designed in the same way as the auditory ossicle prosthesis 1 shown in Figure 2, so that in order to avoid repetition, reference can be made to the explanations of Figures 1A, 1B and 2 for the explanation of Figures 3A and 3B.

[0062] In the exemplary embodiment of an auditory ossicular prosthesis 1 according to the invention shown in Figures 4A and 4B, the windows 6 or recesses 7 are open on one side edge of the fastening element 2, and the spring tabs 8 are arranged on the side edges of the fastening element 2. Spring tabs 8 are arranged on both side edges of the fastening element 2, which in the exemplary embodiment are offset from one another in a circumferential direction. However, spring tabs 8 can also be arranged next to one another on both side edges of the fastening element 2 without any offset in the circumferential direction (not shown).

[0063] In the embodiment of an auditory ossicle prosthesis 1 according to the invention shown in Figures 5A and 5B, the spring tabs 8 are arranged transversely, i.e. they extend axially parallel instead of in the circumferential direction of the fastening element 2. In this case, an end of the spring tabs 8 facing a side edge of the fastening element 2 is alternately firmly connected to the fastening element 2, and an end of the spring tabs 8 facing the opposite side edge of the fastening element 8 can spring radially relative to the fastening element 8. Thus, in the case of spring tabs 8 adjacent in the circumferential direction of the fastening element 2, the ends of the spring tabs 8 facing opposite side edges of the fastening element 2 are alternately firmly connected to the fastening element 2.

[0064] In the exemplary embodiment of an auditory ossicular prosthesis 1 according to the invention shown in Figures 6A and 6B, the spring tabs 8 again extend in the circumferential direction of the fastening element 2, but both circumferential ends of the spring tabs 8 merge integrally into the fastening element 2 or are fixedly arranged on the fastening element 2. Central regions of the spring tabs 8 spring radially to the fastening element 2, similar to leaf springs clamped on both sides.

[0065] With the exception of the differences explained, the auditory ossicle prostheses 1 of all embodiments of the invention shown in the drawing are of the same design.

[0066] In all embodiments of the invention, one or more spring tabs 8 are possible in the fastening element 2, which optionally merge into the fastening element 2 at one end and whose other ends are radially springy or which merge into the fastening element 2 at both ends.

Claims

Patent claims 1. An auditory ossicle prosthesis with a fastening element (2) for fastening to an auditory ossicle, wherein the fastening element (2) has the shape of a partial ring which is open in a circumferential section and extends over more than 180° in a circumferential direction and which has an opening (4) extending over the circumferential section for placing the fastening element (2) on the auditory ossicle, characterized in that the fastening element (2) has at least one recess (7) which is open on an inner circumference of the fastening element (2), in which recess a spring element (9) is arranged which projects inwards from the fastening element (2) beyond the inner circumference of the fastening element (2).

2. Auditory ossicle prosthesis according to claim 1, characterized in that the fastening element (2) has two or more spring elements (9) which are offset from one another in the circumferential direction of the fastening element (2).

3. Auditory ossicle prosthesis according to claim 1 or 2, characterized in that the fastening element (2) is plastically deformable.

4. An auditory ossicular prosthesis according to one or more of claims 1 to 3, characterized in that the auditory ossicular prosthesis (1) has a spring tab (8) as a spring element (9), which is arranged in the recess (7) open on the inner circumference of the fastening element (2) and which extends in the recess (7) in an arcuate manner with a gradient in the circumferential direction of the fastening element (2) such that the spring tab (8) projects inwards beyond the inner circumference of the fastening element (2) at a circumferential point of the fastening element (2) or in a circumferential section of the fastening element (2) and which springs radially to the fastening element (2).

5. An auditory ossicle prosthesis according to claim 4, characterized in that the fastening element (2) has a partially annular strip which is open in the peripheral section, that the strip has a window (6) which forms the recess (7) open on the inner circumference of the fastening element (2), and that the spring tab (8) is arranged in the window (6).

6. An auditory ossicle prosthesis according to claim 4 or 5, characterized in that one circumferential end of the spring tab (8) merges integrally into the fastening element (2) and another circumferential end of the spring tab (8) is free and projects inwards beyond the inner circumference of the fastening element (2).

7. Auditory ossicle prosthesis according to one or more of the preceding claims, characterized in that the spring element (9) and the fastening element (2) are in one piece.

8. An auditory ossicle prosthesis according to one or more of the preceding claims, characterized in that the fastening element (2) has spring elements (9) laterally offset from one another and / or spring elements (9) arranged on both side edges of the fastening element (2).

9. An auditory ossicle prosthesis according to one or more of the preceding claims, characterized in that the fastening element (2) has spring tabs (8) or spring elements (9) arranged axially parallel to the fastening element (2).

10. An auditory ossicular prosthesis according to one or more of the preceding claims, characterized in that the spring tab (8) or the spring element (9) has a tooth-like profile on its inner circumference.

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