Reconstruction of the ossicular chain in the middle ear with glass ionomer cement

The aim of this study is to describe a method to repair small defects (1 to 2 mm) of the ossicular chain by means of glass ionomer cement (GIC) alone. Larger defects can be repaired with a combination of GIC and a platinum wire prosthesis. GIC is a two-component hybrid material consisting of inorganic glass particles surrounded by an insoluble hydrogel matrix. GIC has been used by dentists for many years, but only a few reports describe the use of GIC in human middle ear surgery. Many investigators have proved that most GICs are biocompatible, biostable, and well tolerated by bone and soft tissue.

From 1994 to 1996 GIC was used in 97 middle ear operations. In 44 cases small defects of the ossicular chain were reconstructed with GIC alone. The observation period ranged from 1 to 4 years.

Nearly all operations were performed with the patient under local analgesia.

The postoperative air-bone gap was less than 20 dB in 83.3%. Compared with results from comparable operations, the GIC results are significantly better. One patient had reoperation because the cement had loosened from the bone as a result of faulty GIC operation technique.

Repair of defects of the ossicular chain with GIC is an easy, efficient, quick, and inexpensive method, which ought to be kept in mind for future middle ear surgery. No complications in the middle ear were related to GIC.