Hydroxylapatite ossicular replacement prostheses: results in 157 consecutive cases

The use of hydroxylapatite for ossicular chain reconstruction is increasing. In this study, hearing results and extrusion rate for 157 consecutive patients receiving hydroxylapatite prostheses were evaluated. Results were compared to those of a control group of patients who had received either homograft bone or Plasti-Pore prostheses. Four (2.6%) cases of extrusion have occurred. Hearing success was defined as a postoperative puretone average air-bone gap of < or = 15 dB for incus prostheses and partial ossicular replacement prostheses (PORPs) or < or = 25 dB for incus-stapes prostheses and total ossicular reconstruction prostheses (TORPs). Overall success rate in the hydroxylapatite group was 51.4% for the 140 patients with postoperative data (mean follow-up, 11.5 months) and 46.7% for 90 patients who were followed for more than 6 months (mean follow-up, 16 months). PORP results were significantly poorer than those of the other prostheses. The success rate for the control group was 58.6% for 58 patients. The difference between hydroxylapatite and control group success rates appears to be due to the poorer results of the hydroxylapatite PORP.