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Ossiculoplasty in young children with the Applebaum incudostapedial joint prosthesis
E L Schwetschenau1, G Isaacson
1Department of Otolaryngology, Temple University, Philadelphia, Pennsylvania, USA.
Insights
The Applebaum incudostapedial joint prosthesis offers excellent hearing outcomes and long-term stability in young children, even with recurrent otitis media. This hydroxylapatite prosthesis is a viable option for incudostapedial discontinuity repair.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Biomaterials in Otologic Surgery
Background:
- Incus interposition has been a traditional method for repairing incudostapedial discontinuity.
- Hydroxylapatite ossicular prostheses offer a potential alternative with unique properties.
Purpose of the Study:
- To evaluate the performance of the Applebaum incudostapedial joint prosthesis in young children.
- Assess hearing results and long-term stability.
- Determine efficacy despite eustachian tube dysfunction and otitis media.
Main Methods:
- Retrospective review of Applebaum prostheses implanted in children between June 1993 and June 1998.
- Analysis of hearing outcomes and prosthesis stability.
Main Results:
- All 12 operated ears healed successfully.
- All Applebaum prostheses demonstrated long-term stability (average duration 2.6 years).
- Excellent hearing results were achieved, with a mean air-bone gap of 15 dB.
Conclusions:
- The Applebaum prosthesis effectively restores conductive hearing in young children.
- The prosthesis exhibits stability in the presence of recurrent otitis media.
- Consideration of this prosthesis during primary cholesteatoma surgery in children is recommended.
Objective:
To evaluate the performance of the Applebaum incudostapedial joint prosthesis in young children in terms of hearing results and long-term stability despite continuing eustachian tube dysfunction and otitis media.
Study Design:
Retrospective review of all Applebaum prostheses placed in children at our institution from June 1993 to June 1998.
Results:
In 1993 Applebaum proposed the use of a hydroxylapatite ossicular prosthesis as an alternative to incus interposition for the repair of incudostapedial discontinuity. We have used this prosthesis exclusively for the repair of such defects in children over the past 5 years. Among 12 operated ears, all healed, all prostheses remain in place (average duration, 2.6 y), and all children have excellent hearing (mean air-bone gap, 15 dB; range, 5-25 dB).
Conclusions:
The Applebaum incudostapedial joint prosthesis restores conductive hearing even in young children. It has been stable in the face of recurrent otitis media and has not interfered with revision surgery. Placement of the prosthesis at primary cholesteatoma surgery should be considered in children.