Evaluation of hydroxyapatite ossicular chain prostheses.

Area of Science:

• Biomaterials Science
• Otolaryngology
• Surgical Innovation

Background:

• Hydroxyapatite (HA) prostheses are increasingly used in middle ear surgery.
• They serve as alternatives to autografts and homografts for ossicular chain reconstruction.
• Different types of HA prostheses exist, including total and partial ossicular chain prostheses and incus struts.

Purpose of the Study:

• To evaluate the efficacy of three types of hydroxyapatite (HA) middle ear prostheses.
• To compare hearing outcomes based on the type of HA prosthesis used.
• To investigate the influence of prognostic risk factors on hearing results.

Main Methods:

• A single-surgeon study involving 33 consecutive cases.
• Utilized three types of HA prostheses: total ossicular chain prostheses, partial ossicular chain prostheses, and Kartush incus struts.
• Analyzed postoperative air-bone gap and air-bone gap closure.
• Assessed prognostic risk factors using the Middle Ear Risk Index.

Main Results:

• Statistically significant differences in mean postoperative air-bone gap and air-bone gap closure were observed among the prosthesis types.
• Incus struts showed a mean air-bone gap of 14 dB and closure of 26 dB.
• Partial ossicular chain prostheses had a mean air-bone gap of 22 dB and closure of 11 dB.
• Total ossicular chain prostheses had a mean air-bone gap of 25 dB and closure of 10 dB.
• Higher Middle Ear Risk Index scores correlated with a tendency for worse postoperative hearing.

Conclusions:

• Hydroxyapatite (HA) ossicular prostheses are effective for middle ear reconstruction.
• The study supports the use of HA prostheses, particularly utilizing the malleus for ossicular chain construction.
• Prognostic factors, such as those in the Middle Ear Risk Index, should be considered in surgical planning.