Ossicular reconstruction using hydroxyapatite prostheses with interposed cartilage.
OBJECTIVE
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.


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 (chi(2) = 4.986; P =.03). There was no significant difference between the two groups in the postoperative air-bone gap.


CONCLUSIONS
This procedure is an effective method for reducing the extrusion rate of hydroxyapatite prostheses without reducing the hearing gain resulting from ossiculoplasty.
Kobayashi
Taisuke
T
Department of Otolaryngology, Ehime University School of Medicine, Ehime, Japan. takobaya@m.ehime-u.ac.jp
Gyo
Kiyofumi
K
Shinohara
Takayuki
T
Yanagihara
Naoaki
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D017886:Durapatite; D005500:Follow-Up Studies; D006309:Hearing; D006801:Humans; D008875:Middle Aged; D009998:Ossicular Prosthesis; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D001672:Biocompatible Materials; D017886:Durapatite