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Ossicular reconstruction with titanium prosthesis.

Angela D Martin1, Stephen G Harner

  • 1Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.

The Laryngoscope
|January 8, 2004
PubMed
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Titanium prostheses, including total ossicular replacement prosthesis (TORP) and partial ossicular replacement prosthesis (PORP), demonstrate good outcomes for chronic ear disease surgery. These implants are well-tolerated, with significant air-bone gap improvement in most patients.

Area of Science:

  • Otolaryngology
  • Biomaterials in reconstructive surgery
  • Auditory rehabilitation

Background:

  • Chronic ear disease often necessitates ossicular reconstruction.
  • Titanium prostheses (TORP and PORP) are utilized for this purpose.
  • Evaluating the efficacy of titanium implants is crucial for surgical decision-making.

Purpose of the Study:

  • To assess the outcomes of titanium total ossicular replacement prosthesis (TORP) and partial ossicular replacement prosthesis (PORP) in chronic ear disease surgery.
  • To analyze factors influencing hearing results, such as procedure type and surgical history.

Main Methods:

  • A retrospective chart review of 68 ossicular reconstruction procedures using titanium TORP or PORP.
  • Procedures were performed between December 1999 and June 2002 at a tertiary referral center.

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  • Follow-up duration ranged from 3 months to 2.5 years.

    • Main Results:

    • Titanium prostheses showed ease of insertion, good tissue tolerance, and a low extrusion rate.
    • An average air-bone gap improvement of 13 dB was achieved, with 57% of cases closing the gap to within 20 dB.
    • Hearing outcomes were superior in primary surgeries, for PORPs compared to TORPs, and in intact canal wall procedures versus canal wall-down procedures.

    Conclusions:

    • Titanium is a suitable material for ossicular reconstruction due to its favorable insertion characteristics, tissue compatibility, and low extrusion rates.
    • Careful patient selection is recommended for revision surgeries, particularly when the canal wall and stapes superstructure are compromised.