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Related Experiment Videos

Ossicular chain reconstruction: titanium versus plastipore.

Todd A Hillman1, Clough Shelton

  • 1Division of Otolaryngology, University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USA.

The Laryngoscope
|October 2, 2003
PubMed
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A new titanium ossicular replacement prosthesis showed comparable hearing results to Plastipore prostheses. However, Plastipore performed better in specific surgical scenarios, particularly canal wall up mastoidectomies.

Area of Science:

  • Otolaryngology
  • Biomaterials Science
  • Surgical Innovation

Background:

  • Ossicular replacement prostheses are crucial in middle ear reconstructive surgery.
  • Evaluating new biomaterials like titanium is essential for improving surgical outcomes.
  • Plastipore prostheses have been a standard, necessitating comparative analysis of alternatives.

Purpose of the Study:

  • To compare the complication rates and hearing outcomes of a novel titanium ossicular replacement prosthesis against established Plastipore prostheses.
  • To assess the efficacy of titanium prostheses in various tympanoplasty and mastoidectomy procedures.

Main Methods:

  • A retrospective chart review was conducted.
  • Data analyzed included prosthesis type, extrusion and failure rates, and hearing thresholds (four-frequency average air-bone gap).

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  • Follow-up points and surgical approaches (e.g., canal wall up) were considered.

    • Main Results:

    • The titanium group (53 patients) had one extrusion and one failure; the Plastipore group (84 patients) had no extrusions or failures.
    • Overall hearing results were comparable, with average air-bone gaps of 22.0 dB for titanium and 19.3 dB for Plastipore (P=.08).
    • Plastipore demonstrated better outcomes in canal wall up procedures (17.8 dB vs. 23.9 dB) and tended towards better results with total ossicular replacement (22 dB vs. 27 dB).

    Conclusions:

    • The titanium prosthesis offers comparable hearing results to Plastipore and provides excellent visualization.
    • Plastipore prostheses exhibited superior performance in canal wall up mastoidectomies and when total ossicular replacement was indicated.
    • Both prostheses have roles, with titanium being a viable alternative, though Plastipore shows advantages in specific reconstructive contexts.