[Middle ear ossicular replacement prostheses: cause of failure]

Area of Science:

• Otolaryngology
• Biomedical Engineering
• Surgical Outcomes Research

Context:

• Chronic middle ear disease often necessitates surgical intervention, specifically ossiculoplasty, to restore hearing.
• Various prostheses exist for ossiculoplasty, with Plastipores being a commonly utilized option.
• Understanding the efficacy and failure modes of specific prostheses is crucial for optimizing surgical practice.

Purpose:

• To evaluate the outcomes of ossiculoplasty utilizing Plastipores prostheses in a large cohort of patients.
• To identify the causes of prosthesis failure and recurrence of disease following surgery.
• To determine factors influencing the success of air-bone gap closure in ossiculoplasty.

Summary:

• Ossiculoplasty with Plastipores was performed in 237 cases over five years.
• Complications included tympanic membrane perforation recurrence (23.2%), cholesteatoma recurrence (6.8%), and prosthesis extrusion (4.2%).
• Successful eradication of underlying ear disease was achieved in 65.8% of patients, with significant air-bone gap closure in 55.8% (within 20 dB) and 44.2% (over 20 dB).

Impact:

• Surgeon experience, disease severity, Eustachian tube function, ossicular chain integrity, surgical approach, and prosthesis characteristics are critical determinants of ossiculoplasty success.
• This study provides valuable data for surgeons selecting prostheses and managing patients undergoing ossiculoplasty for chronic middle ear disease.
• Findings highlight areas for potential improvement in prosthesis design and surgical techniques to minimize failure rates.