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Ossicular reconstruction using hydroxyapatite prostheses with interposed cartilage.

Taisuke Kobayashi1, Kiyofumi Gyo, Takayuki Shinohara

  • 1Department of Otolaryngology, Ehime University School of Medicine, Ehime, Japan. takobaya@m.ehime-u.ac.jp

American Journal of Otolaryngology
|July 10, 2002
PubMed
Summary

Interposing cartilage with hydroxyapatite prostheses significantly reduces extrusion rates. This effective method improves outcomes for ossiculoplasty without compromising hearing gain.

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Area of Science:

  • Otolaryngology
  • Biomaterials Science
  • Surgical Innovation

Background:

  • Hydroxyapatite prostheses offer excellent biocompatibility for ossicular reconstruction.
  • Prosthesis extrusion, often due to eardrum retraction, remains a long-term complication.
  • Autologous cartilage interposition is empirically used to prevent extrusion, but its efficacy is unproven.

Purpose of the Study:

  • To evaluate the effect of cartilage interposition on the extrusion rate of hydroxyapatite ossicular prostheses.
  • To assess the impact of cartilage interposition on hearing outcomes after ossiculoplasty.

Main Methods:

  • A comparative study involving 54 ears with cartilage interposition and 53 ears without.
  • Evaluation of otoscopic findings and hearing outcomes three years post-surgery.

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Main Results:

  • The extrusion rate was significantly lower in the cartilage interposition group (1.9%) compared to the no-interposition group (13.2%) (P =.03).
  • No significant difference in postoperative air-bone gap was observed between the two groups.

Conclusions:

  • Cartilage interposition is an effective surgical technique to reduce hydroxyapatite prosthesis extrusion.
  • This procedure enhances the success of ossiculoplasty by minimizing extrusion without negatively impacting hearing results.