Ossicular reconstruction using hydroxyapatite prostheses with interposed cartilage

• Published in: American journal of otolaryngology 2002-07, Vol.23 (4), p.222-227
• Main Authors: Kobayashi, Taisuke, Gyo, Kiyofumi, Shinohara, Takayuki, Yanagihara, Naoaki
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biocompatible Materials; Biological and medical sciences; Cartilage - transplantation; Child; Durapatite; Follow-Up Studies; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Hearing; Humans; Medical sciences; Middle Aged; Ossicular Prosthesis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the ear, the auditive nerve and the facial nerve; Technology. Biomaterials. Equipments; Transplantation, Autologous; Treatment Outcome
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1053/ajot.2002.124191

Purpose: Despite the excellent biocompatibility of hydroxyapatite ossicular prostheses, extrusion of the prosthesis may be found during long-term follow-up, mainly due to the retraction of the eardrum. Although interposition of autologous cartilage between the eardrum and the prosthesis is empirically used to prevent extrusion, the clinical effect of this procedure has not been confirmed. The purpose of this study was to evaluate the effect of interposing a cartilage on the extrusion rate and hearing outcome. Materials and Methods: Fifty-four ears in which cartilage was interposed with a hydroxyapatite prosthesis were compared with 53 ears without interposition. Three years after surgery, the otoscopic findings and hearing outcome were evaluated. Results: The extrusion rate was 1.9% in the group with interposition and 13.2% in the group without interposition. The difference between the two groups was statistically different (X2 = 4.986; P =.03). There was no significant difference between the two groups in the postoperative air-bone gap. Conclusion: This procedure is an effective method for reducing the extrusion rate of hydroxyapatite prostheses without reducing the hearing gain resulting from ossiculoplasty. (Am J Otolaryngol 2002;23:222-227. Copyright 2002, Elsevier Science (USA). All rights reserved.)