Reconstruction of the ossicular chain with titanium implants

Area of Science:

• Otolaryngology
• Biomaterials Science
• Surgical Innovation

Background:

• Over 1300 titanium implants have been utilized since 1994 for middle ear ossicular chain reconstruction in chronic otitis media.
• Two implant types, fixed and adjustable length, from two companies, have been used.
• Patient follow-up ranged from 6 to 72 months post-surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of titanium implants in ossicular chain reconstruction.
• To assess hearing outcomes and complication rates associated with titanium prostheses.
• To determine the suitability of titanium implants for various anatomical situations.

Main Methods:

• A cohort of patients aged 5 to 82 years undergoing tympanoplasty type III with titanium ossicular chain reconstruction was evaluated.
• Implants from two manufacturers, one fixed-length and one trimmable, were assessed.
• Evaluation included postoperative follow-up and hearing outcome analysis.

Main Results:

• A very low complication rate was observed, with extrusions occurring in less than 1% of cases, primarily associated with atelectasis and cartilage resorption.
• No adverse reactions to the titanium prostheses were noted, even in histological reviews.
• Excellent hearing results were achieved: 76% of patients had an average air-bone gap < 20 dB(A), and 43% had an air-bone gap < 10 dB(A).

Conclusions:

• Titanium implants offer significant benefits, including high biocompatibility and stability, for ossicular chain reconstruction.
• The use of titanium prostheses is associated with a very low complication rate and excellent hearing results.
• Titanium implants are highly recommended for reconstructing the middle ear's ossicular chain.