Hydroxyapatite versus titanium ossiculoplasty.
OBJECTIVE
To compare the results of ossicular chain reconstruction using hydroxyapatite (HA) and titanium (TI) prostheses.


METHODS
Retrospective study and case series.


METHODS
Tertiary referral center.


METHODS
One hundred sixty-eight patients presenting chronic otitis media with or without cholesteatoma.


METHODS
Ossiculoplasty using partial or total HA and TI ossicular replacement prostheses (TORP and PORP, respectively).


METHODS
Patients were assessed at 2 months postoperatively to establish short-term results. Results of treatment for conductive hearing loss were reported according to guidelines. Available audiometric data at 1, 2, 3, and 5 years were used to assess prosthesis stability. Average postoperative air-conduction gain, air-bone gap, and sensorineural hearing level were measured at four frequencies: 0.5, 1, 2, and 4 kHz. Statistical analyses compared outcomes for HA TORP versus TI TORP and HA PORP versus TI PORP.


RESULTS
Postoperative air-bone gap of less than 20 dB was obtained in 50% of HA TORP versus 45.8% of TI TORP cases and in 63.2% of HA PORP versus 72% of TI PORP cases. Preoperative middle ear status and presence/absence of malleus significantly influenced postoperative audiometric results. All types of prosthesis demonstrated significant postoperative air-conduction gain decrease on follow-up. Prosthesis exclusion was observed in three cases (1.78%).


CONCLUSIONS
Prostheses using both types of biomaterial gave good functional results and stability with low exclusion rates, with no statistically significant differences between the two. Trends could be observed for slightly better results for HA in total reconstruction and for TI in partial reconstruction. The degradation in postoperative functional gain seemed to be independent of prosthesis type.
Truy
Eric
E
Department of Otolaryngology, Head and Neck Surgery and Phoniatrics, Edouard Herriot Hospital, Lyon, France. eric.truy@chu-lyon.fr
Naiman
Anna Nuca
AN
Pavillon
Clemence
C
Abedipour
Darius
D
Lina-Granade
Geneviève
G
Rabilloud
Muriel
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000737:chemistry*; D001844:Bone Conduction / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D017886:Durapatite / Q000737:chemistry*; D004429:Ear Ossicles / Q000033:anatomy & histology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement; D010033:Otitis Media / Q000150:complications; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D014025:Titanium / Q000737:chemistry*; D016896:Treatment Outcome
D001672:Biocompatible Materials; D017886:Durapatite; D014025:Titanium