title: Hydroxylapatite ossicular replacement prostheses: preliminary results.
abstract: Hearing results and extrusion rate for 89 consecutive patients receiving hydroxylapatite prostheses for hearing reconstruction were evaluated and compared to a control group of 75 patients who had received homograft bone or Plasti-Pore prostheses. At the 3-month follow-up, there were no cases of extrusion of the hydroxylapatite prostheses. Hearing success was defined as a postoperative air-bone gap of less than or equal to 15 dB for incus prostheses and partial ossicular replacement prostheses or less than or equal to 25 dB for incus-stapes prostheses and total ossicular replacement prostheses. There was a statistically significant difference in the distribution-of-success rate by prosthesis type for the hydroxylapatite. Incus, incus-stapes, and total ossicular replacement prosthesis results were similar, but partial ossicular replacement prosthesis results were poorer. The overall success rate in the hydroxylapatite group was 51.2%; in the control group, it was 60%. Hearing results tended to be better with the hydroxylapatite incus prosthesis than with the homograft bone incus, but poorer with the hydroxylapatite partial ossicular replacement prosthesis than with the Plasti-Pore. Several technical modifications of the prosthesis that may improve results with the hydroxylapatite partial ossicular replacement prosthesis are suggested. Hydroxylapatite middle ear prostheses appear to be a reasonable alternative to other more commonly used prostheses, which carry disadvantages related to the use of human tissue.
authors.affiliation: Department of Otolaryngology, School of Medicine, Wright State University, Dayton, Ohio.
authors.forename: R A
authors.initials: RA
authors.lastname: Goldenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001672:Biocompatible Materials; D002648:Child; D017886:Durapatite; D004429:Ear Ossicles / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D006882:Hydroxyapatites; D008875:Middle Aged; D011095:Polyethylenes; D011126:Polypropylenes; D011379:Prognosis; D019736:Prostheses and Implants; D012189:Retrospective Studies
chemical_list: D001672:Biocompatible Materials; D006882:Hydroxyapatites; C016674:Plastipore; D011095:Polyethylenes; D011126:Polypropylenes; D017886:Durapatite