Titanium versus nontitanium ossicular prostheses-a randomized controlled study of the medium-term outcome

Area of Science:

• Otolaryngology
• Biomaterials Science
• Surgical Innovation

Background:

• Chronic otitis media often necessitates ossicular reconstruction.
• Titanium (Ti) and hydroxyapatite (HA) prostheses are used in ossiculoplasty.
• Comparing the medium-term outcomes of these prostheses is crucial for clinical decision-making.

Purpose of the Study:

• To compare the medium-term clinical outcomes of ossiculoplasty using titanium versus nontitanium (hydroxyapatite) prostheses.
• To evaluate hearing gain and prosthesis extrusion rates between the two prosthesis types.

Main Methods:

• A randomized controlled, prospective clinical trial was conducted.
• Patients with chronic otitis media requiring partial or total ossicular reconstruction were included, excluding trauma and congenital cases.
• Titanium (Ti) and hydroxyapatite (HA) prostheses were used for reconstruction, with a cartilage plate covering the Ti head plate.

Main Results:

• Mean hearing gain was comparable between HA and Ti prostheses for both partial ossicular replacement prostheses (PORPs) and total ossicular replacement prostheses (TORPs).
• No statistically significant difference in hearing gain was observed between HA and Ti groups for PORPs (14.30 vs 15.10 dB) or TORPs (13.52 vs 13.48 dB).
• Prosthesis extrusion rates did not significantly differ between the titanium and hydroxyapatite groups.

Conclusions:

• The study found no significant clinical difference between titanium and hydroxyapatite prostheses in medium-term ossiculoplasty outcomes.
• The observed lack of statistical difference may be attributed to the small sample size and limited statistical power of the randomized controlled trial.
• Further research with larger cohorts is needed to definitively compare the efficacy of different ossiculoplasty prosthesis materials and surgical techniques.