Hydroxylapatite ossicular replacement prostheses: results in 157 consecutive cases.

Area of Science:

• Otolaryngology
• Biomaterials Science
• Surgical Innovation

Background:

• Ossicular chain reconstruction is crucial for hearing restoration.
• Hydroxylapatite prostheses are increasingly utilized in otologic surgery.
• Evaluating the efficacy and safety of new biomaterials is essential.

Purpose of the Study:

• To assess hearing outcomes and extrusion rates of hydroxylapatite prostheses in ossicular chain reconstruction.
• To compare the performance of hydroxylapatite prostheses against traditional materials like homograft bone and Plasti-Pore.
• To identify specific hydroxylapatite prosthesis types that may have suboptimal results.

Main Methods:

• A retrospective review of 157 consecutive patients undergoing ossicular chain reconstruction with hydroxylapatite prostheses.
• Comparison with a control group receiving homograft bone or Plasti-Pore prostheses.
• Definition of hearing success based on postoperative air-bone gap thresholds for different prosthesis types (incus, partial ossicular replacement prostheses [PORPs], incus-stapes, total ossicular reconstruction prostheses [TORPs]).

Main Results:

• An overall extrusion rate of 2.6% (4 out of 157 patients) was observed.
• The overall hearing success rate for hydroxylapatite prostheses was 51.4% (140 patients) with a mean follow-up of 11.5 months.
• Hydroxylapatite partial ossicular replacement prostheses (PORPs) demonstrated significantly poorer hearing success rates compared to other hydroxylapatite prosthesis types and the control group.

Conclusions:

• Hydroxylapatite prostheses are a viable option for ossicular chain reconstruction with a low extrusion rate.
• The performance of hydroxylapatite prostheses varies by type, with PORPs showing inferior hearing results.
• Further investigation into the design or application of hydroxylapatite PORPs is warranted to improve outcomes.