The use of malleus allografts in ossiculoplasty.
OBJECTIVE
To assess the functional performance of remodeled malleus allografts in a malleus-footplate assembly in terms of hearing results and mid long-term stability.


METHODS
A retrospective study of 60 consecutive patients who underwent a malleus allograft ossiculoplasty from 1993 until 2000. In all cases the incus and the stapedial arch were missing as the result of cholesteatoma (49), chronic otitis (5), incus necrosis resulting from stapes prosthesis (5), and congenital ossicular malformations (1). In all cases malleus allografts were remodeled to form a malleus-stapes assembly.


RESULTS
The audiometric results, using such an ossiculoplasty, revealed an overall median gain of 18.3 dB at 2 months, 22.3 dB at 6 months, and 25 dB 1 year postoperatively on Fletcher frequencies. An air-bone gap closure within 20 dB was achieved in 81% of all cases 1 year postoperatively. No cases of extrusion have been seen in our series.


CONCLUSIONS
Our findings suggest that malleus allografts are capable of generating good and stable functional results as malleus-stapes assembly.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000601:surgery; D004429:Ear Ossicles / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008307:Malleus / Q000637:transplantation*; D008875:Middle Aged; D019933:Ossicular Replacement; D011183:Postoperative Complications; D012189:Retrospective Studies; D014184:Transplantation, Homologous