title: Tympano-ossiculoplasty utilizing the Spiggle and Theis titanium total ossicular replacement prosthesis.
abstract: OBJECTIVE
  Since 1993, titanium prostheses have been used in Europe as a biocompatible implant for ossicular reconstruction. More recently, the titanium ossicular prosthesis has become more widely available in the United States as a newer means of surgical restoration of hearing. We will review the hearing results of patients who have undergone tympano-ossiculoplasty using a titanium total ossicular replacement prosthesis (TOP). We will compare these results to our previously published results using the porous polyethylene TOP.
  
  
  METHODS
  Retrospective review in a tertiary otologic practice.
  
  
  RESULTS
  Eighteen patients underwent tympano-ossiculoplasty with a titanium TOP. Among these patients, 10 cases involved revision of a previously placed ossicular prosthesis. Hearing results showed that 16 of 18 patients (89%) had closure of the postoperative air-bone gap to within 20 dB, and the average air-bone gap improvement was 23 dB. The average follow-up time was 8 months (range, 2-21 months). The results of this initial evaluation compare favorably with the results that we obtained using a porous polyethylene TOP in which 67% of 133 patients closed the air-bone gap to within 20 dB.
  
  
  CONCLUSIONS
  We have recently begun using the titanium TOP, which has resulted in improved postoperative hearing when compared with the porous polyethylene TOP. In the future, longer follow-up and increased patient numbers will strengthen our conclusions.
authors.affiliation: The Lippy Group for Ear, Nose, & Throat, Warren, Ohio, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Neff
authors.forename: Franklin M
authors.initials: FM
authors.lastname: Rizer
authors.forename: Arnold G
authors.initials: AG
authors.lastname: Schuring
authors.forename: William H
authors.initials: WH
authors.lastname: Lippy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D001672:Biocompatible Materials; D001844:Bone Conduction / Q000502:physiology; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012086:Reoperation; D012189:Retrospective Studies; D013069:Speech Reception Threshold Test; D014025:Titanium; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*
chemical_list: D001672:Biocompatible Materials; D014025:Titanium