Use of Mimix hydroxyapatite bone cement for difficult ossicular reconstruction.
OBJECTIVE
To describe the advantages of using Mimix hydroxyapatite (HA) bone cement in reconstructing a variety of ossicular chain abnormalities.


METHODS
Case series at a tertiary medical center.


RESULTS
Twenty-five cases of HA reconstruction are included in this series (ages 23-74; mean, 47 years). The examples presented include (1) HA as the sole reconstructive material for incus erosion, (2) HA for securing a total or partial ossicular replacement prosthesis, (3) incus augmentation after crimping for revision stapedotomy with incus erosion, (4) HA in primary stapedotomy to fix the crimped prosthesis to an intact incus, and (5) other unique situations. Preoperative and postoperative audiograms were evaluated for 4-tone pure tone average (PTA), speech reception thresholds, word recognition scores, and air-bone gaps (AB gaps). Mean follow-up was 11 months (range 2 to 22 months). The mean PTA improved from 57 dB to 37 dB, whereas the mean AB gaps decreased from 33 dB to 16 dB. There were no cases of infection or extrusion.


CONCLUSIONS
Hydroxyapatite bone cement is an excellent adjunct or alternative to ossiculoplasty with preformed prostheses. Easily malleable, rapidly setting, and rapidly hardening, Mimix is particularly well suited for middle ear work.


CONCLUSIONS
Definitive fixation with bone cements during difficult ossicular chain reconstruction may ensure a more enduring successful outcome.
Goebel
Joel A
JA
Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis, 660 S. Euclid, Campus Box 8115, St. Louis, MO 63110, USA. goebelj@msnotes.wustl.edu
Jacob
Abraham
A
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D004429:Ear Ossicles / Q000601:surgery*; D005260:Female; D006801:Humans; D006882:Hydroxyapatites / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019933:Ossicular Replacement / Q000379:methods; D013506:Otologic Surgical Procedures; D019651:Plastic Surgery Procedures; D012086:Reoperation; D013201:Stapes Surgery; D014432:Tympanic Membrane / Q000601:surgery; D018058:Tympanic Membrane Perforation / Q000601:surgery
D006882:Hydroxyapatites; C475044:hydroxyapatite cement