Is cartilage interposition required for ossiculoplasty with titanium prostheses?

Area of Science:

• Otolaryngology
• Biomaterials Science
• Surgical Innovation

Background:

• Ossiculoplasty aims to restore hearing by reconstructing the middle ear ossicular chain.
• Titanium prostheses are commonly used in ossiculoplasty.
• The necessity of cartilage interposition between the prosthesis and tympanic membrane is debated.

Purpose of the Study:

• To evaluate the necessity of cartilage interposition for preventing extrusion of titanium prostheses.
• To assess the interaction between titanium prosthesis heads and the tympanic membrane.
• To analyze audiometric outcomes in ossiculoplasty using titanium prostheses.

Main Methods:

• Retrospective review of 73 ossiculoplasty cases.
• Patients aged 5.9 to 64.5 years.
• Utilized Spiggle and Theis and Grace Alto titanium prostheses (PORP and TORP).

Main Results:

• Five extrusions occurred in 4 patients over 6-98 months.
• Extrusions were linked to tympanic membrane retraction.
• Audiometric results were comparable to other ossiculoplasty techniques.

Conclusions:

• Titanium prosthesis heads demonstrate good interaction with the tympanic membrane.
• Cartilage interposition is not essential in cases with favorable middle ear conditions.
• This study supports the use of titanium prostheses without cartilage interposition.