title: Ossiculoplasty with a cartilage-connecting hydroxyapatite prosthesis for tympanosclerotic stapes fixation.
abstract: Many cases of tympanosclerotic stapes fixation are accompanied by fixation or erosion of malleus and/or incus. This status of the ossicular chain is one of the reasons that ossiculoplasty for tympanosclerotic stapes fixation is more difficult than that for otosclerosis. We conducted a retrospective review of seven patients who were operated on for tympanosclerotic stapes fixation between 2002 and 2006. All of the patients had abnormal conditions of the malleus and/or incus and underwent stapedectomy and total ossiculoplasty with hydroxyapatite prosthesis (Apaceram T-7 type), which has a planar-like head portion that contacts a piece of cartilage. Postoperative hearing results were assessed in all seven patients after at least 1 year. The postoperative air-bone gap (ABG) was closed within 10 dB in two of seven patients, and was less than 20 dB in six of seven patients. The mean postoperative ABG was closed within 10 dB at 1 and 2 kHz and less than 20 dB at low frequencies (0.25 and 0.5 Hz). There was almost no hearing improvement at high frequencies (4 and 8 kHz). There were no patients with postoperative sensorineural hearing loss. The present study shows that stapedectomy and total ossiculoplasty with cartilage-connecting hydroxyapatite prosthesis is effective and safe for stapes fixation accompanied by fixation or erosion of the malleus and/or incus.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Miyazaki University, 5200 Kihara, Kiyotake-cho, Miyazaki 889-1692, Japan. kawahiro@med.miyazaki-u.ac.jp
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kawano
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsuda
authors.forename: Haruka
authors.initials: H
authors.lastname: Nakanishi
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Toyama
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nagai
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tono
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction; D002356:Cartilage / Q000601:surgery*; D017886:Durapatite; D005260:Female; D005500:Follow-Up Studies; D006316:Hearing Loss, High-Frequency / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods*; D010040:Otosclerosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011474:Prosthesis Design; D012189:Retrospective Studies; D013063:Speech Discrimination Tests; D013201:Stapes Surgery; D053831:Surgical Fixation Devices
chemical_list: D017886:Durapatite