title: Preliminary ossiculoplasty results using the Kurz titanium prostheses.
abstract: OBJECTIVE
  Limitations in biocompatibility and hearing improvement with ossicular chain reconstruction prostheses are addressed with new, lightweight titanium prostheses designed to maximize visualization of the capitulum and footplate regions. The effectiveness of these new prostheses is being tested in a prospective multicenter study.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Multicenter (8 sites), primarily tertiary private practice or academic otologic clinics.
  
  
  METHODS
  A convenience sample of 31 patients undergoing ossiculoplasty, with 16 partial ossicular chain reconstructions using the Bell prosthesis and 15 total reconstructions using the Aerial prosthesis.
  
  
  METHODS
  Ossiculoplasty using new Kurz titanium prostheses. Cartilage was interposed between the tympanic membrane and the prosthesis.
  
  
  METHODS
  Air-bone gap for pure tone average and 3,000 and 4,000 Hz, assessed preoperatively and 3 months, 6 months, and 12 months postoperatively; percent of patients obtaining an air-bone gap of </=20 dB; high-frequency average (1,000, 2,000, and 4,000 Hz) to evaluate sensorineural hearing loss; and extrusion rate.
  
  
  RESULTS
  A postoperative air-bone gap of </=20 dB was obtained in 81% of Bell prosthesis patients and 67% of Aerial prosthesis patients at 3 months. The results were stable to improved for later time intervals. High-frequency gaps were similar to the pure tone average gap. To date, there have been no instances of extrusion, and all the surgeons found the prostheses easy to use and thought that the design characteristics facilitated accurate placement.
  
  
  CONCLUSIONS
  Initial evaluation of the Kurz titanium prostheses produced low extrusion rates (none to date) with excellent hearing results, including good high-frequency conduction. Good visualization and accurate placement were easy to achieve. Further studies are needed to confirm long-term efficacy.
authors.affiliation: The Otology Group, San Antonio, TX 78240, USA. weskrueger@yahoo.com
authors.forename: Wesley W O
authors.initials: WW
authors.lastname: Krueger
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Feghali
authors.forename: Clough
authors.initials: C
authors.lastname: Shelton
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Green
authors.forename: Charles W
authors.initials: CW
authors.lastname: Beatty
authors.forename: David F
authors.initials: DF
authors.lastname: Wilson
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Thedinger
authors.forename: David M
authors.initials: DM
authors.lastname: Barrs
authors.forename: John T
authors.initials: JT
authors.lastname: McElveen
mesh_terms: D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D001844:Bone Conduction / Q000502:physiology; D002356:Cartilage / Q000637:transplantation; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D009998:Ossicular Prosthesis; D010897:Pitch Discrimination / Q000502:physiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011446:Prospective Studies; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D014025:Titanium
chemical_list: D014025:Titanium