title: Long term results of the titanium clip prosthesis.
abstract: The objective of the study is to evaluate the long term results of ossiculoplasty using the clip titanium partial ossicular replacement prosthesis. This study retrospectively reviews the partial ossiculoplasty conducted using clip titanium partial ossicular replacement prosthesis at a tertiary referral center. Audiometric outcomes and intraoperative findings were postoperatively measured from revision surgery of 47 ears (20 women, 27 men, mean age 43 years) averaging 6.5 years. The overall air-bone gap decreased from 25.7 dB preoperatively to 16.8 dB 6.5 years postoperatively (p ≤ 0.001, ηp2= 0.210). An air-bone gap of <20 dB was present in 28 % of ears preoperatively and increased to 72 % postoperatively. In revision (n = 30) and primary tympanoplasties (n = 17), the preoperative air-bone gaps were reduced from 28.9 and 20.1 to 18.7 dB (p ≤ 0.001, ηp2= 0.240) and 13.2 dB (p = 0.033, ηp2= 0.192), respectively. In canal wall down (n = 15) procedures and tympanoplasties with intact canal wall (n = 32), the mean air-bone gaps diminished from 28.9 to 18.1 dB (p = 0.02, ηp2= 0.245) and 24.2 to 16.1 dB (p ≤ 0.001, ηp2= 0.221), respectively. In our own revision tympanoplasties (n = 8) and second look operations (n = 6), we found that the prostheses were safe to remove without any deleterious effects. Two prostheses were dislocated from the stapes' head due to recurrent cholesteatoma. Therefore, it can be concluded that ossiculoplasty using the clip partial ossicular replacement prosthesis allows for good and reliable long term hearing results. Also, the flexible strips reveal no adverse effects on the encompassed stapes' head and do not complicate revision surgery.
authors.affiliation: Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 50924, Cologne, Germany. antoniu-oreste.gostian@uk-koeln.de.
authors.forename: Antoniu-Oreste
authors.initials: AO
authors.lastname: Gostian
authors.affiliation: Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 50924, Cologne, Germany.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Kouame
authors.affiliation: Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 50924, Cologne, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bremke
authors.affiliation: Jean-Uhrmacher-Institute for Clinical ENT-Research, Geibelstrasse 29-31, 50931, Cologne, Germany.
authors.forename: Magdalene
authors.initials: M
authors.lastname: Ortmann
authors.affiliation: Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 50924, Cologne, Germany.
authors.forename: Karl Bernd
authors.initials: KB
authors.lastname: Hüttenbrink
authors.affiliation: Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 50924, Cologne, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Beutner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000388:Air; D000704:Analysis of Variance; D001299:Audiometry; D001844:Bone Conduction; D002648:Child; D002781:Cholesteatoma / Q000150:complications; D005260:Female; D006309:Hearing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D019919:Prosthesis Implantation; D012086:Reoperation; D012189:Retrospective Studies; D013199:Stapes; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*
chemical_list: D014025:Titanium
keywords: Clip-prosthesis; Long-term results; Partial ossiculoplasty; Tympanoplasty