title: Titanium angular clip: a new prosthesis for reconstruction of the long process of the incus.
abstract: OBJECTIVE
  To describe a new titanium angular clip prosthesis for bridging the incudostapedial joint in the event of an isolated lesion of the distal end of the long process of the incus.
  
  
  METHODS
  Clinical retrospective study.
  
  
  METHODS
  We retrospectively reviewed the course of 22 patients with isolated defects of the long process of the incus where the ossicular chain was reconstructed by a titanium angular clip prosthesis.
  
  
  RESULTS
  The placement of the prosthesis was successful in all patients, and no complication was encountered during its installation. At the first follow-up visit after 3 weeks, the mean air-bone gap (ABG) was reduced by around 10 dB from a mean of 26 dB preoperatively to 16 dB postoperatively. The mean postoperative hearing result of patients with a Type A tympanogram (7-dB ABG) was consistently better than for patients with a Type B or a Type C tympanogram (19-dB ABG in both).
  
  
  CONCLUSIONS
  Despite the limited number of patients, this preliminary study demonstrates the effectiveness of the angular clip prosthesis in reconstructing the ossicular chain. In cases of a normal aeration of the tympanic cavity, this reliable reconstruction of the biological chain offers a near-to-normal hearing restoration.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany.
authors.forename: Karl-Bernd
authors.initials: KB
authors.lastname: Huttenbrink
authors.forename: Jan Christoffer
authors.initials: JC
authors.lastname: Luers
authors.forename: Dirk
authors.initials: D
authors.lastname: Beutner
mesh_terms: D000158:Acoustic Impedance Tests; D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry; D001672:Biocompatible Materials; D001844:Bone Conduction; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D004429:Ear Ossicles / Q000601:surgery; D005260:Female; D006801:Humans; D007188:Incus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures; D014025:Titanium; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D014025:Titanium