A new ossicle homograft inactivation/preservation procedure: clinical results.
A new NaOH-autoclaving inactivation/preservation procedure (IPP) for ossicle homografts, complying with the actual infectious disease guidelines, has been developed and used in our institution for 5 years. This study compares the clinical and audiological results of middle ear reconstruction using the new NaOH-autoclaving inactivated ossicle homografts (22 patients) and the previously used cialit-formaldehyde inactivation procedure (28 patients). During the follow-up period, no homograft extrusion, resorption or disease transmission was observed either for the NaOH-autoclaving or for the cialit-formaldehyde protocol. A postoperative air-bone gap of less than 20 dB in 44% and a postoperative hearing improvement of 10-50 dB in 70% of patients complies with the published success rates of homograft ossiculoplasty in the literature. The analysis and comparison of both tested IPP-patient groups showed no statistically significant differences in the clinical and the audiological results. The NaOH-autoclaving inactivation/preservation protocol should increase ossicle homograft safety even with respect to prion exposure. The good anatomic and audiological long-term results of the new IPP protocol confirm homograft ossicles as a valid and inexpensive approach for middle ear reconstruction.
Romualdez
Joel A
JA
Department of ENT, Head and Neck Surgery, Inselspital, University of Berne, Berne, Switzerland.
Stauffer
Edouard
E
Häsler
Rudolf
R
Hotz
Michel A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019933:Ossicular Replacement; D014184:Transplantation, Homologous