Revisiting the risks involved in using homograft ossicles in otological surgery

Area of Science:

• Otolaryngology
• Transplant Surgery
• Infectious Disease Control

Background:

• Homograft ossicles are widely used in South Africa for otological procedures.
• Otolaryngologists express reluctance in using homograft ossicles due to perceived risks.
• Ossicular prostheses may be financially inaccessible in developing countries.

Purpose of the Study:

• To review the risks of human immunodeficiency virus (HIV) and Creutzfeldt-Jakob disease (CJD) transmission from homograft ossicles.
• To discuss effective sterilization techniques for homograft ossicles.
• To evaluate the safety and viability of homograft ossicles in ossicular reconstruction.

Main Methods:

• Literature review of otological surgery involving homograft ossicles.
• Analysis of reported cases of HIV and CJD transmission in otological procedures.
• Examination of sterilization methods for viral and prion inactivation.

Main Results:

• No documented cases of HIV transmission via homograft ossicles in otological surgery.
• No reported cases of transmissible spongiform encephalopathy following homograft ossicle use.
• Two otological CJD cases involved dura mater and pericardium, not ossicles.
• HIV is effectively inactivated by standard sterilization techniques.

Conclusions:

• The risk of HIV transmission from homograft ossicles is statistically insignificant with proper sterilization.
• The risk of CJD transmission from homograft ossicles is extremely low.
• Homograft ossicles are a safe and viable alternative for ossicular reconstruction, especially when prostheses are unavailable.