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Updated: May 3, 2026
Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
Published on: January 26, 2024
Is cartilage interposition required for ossiculoplasty with titanium prostheses?
Michael B Pringle1, Vishnu S Sunkaraneni, Neil Tann
1*ENT Department, Queen Alexandra Hospital, Portsmouth; †ENT Department, Royal Surrey County Hospital, Guildford; and ‡ENT Specialist Registrar, Eastern Deanery, Addenbrookes Hospital, Cambridge, UK.
Objective:
To demonstrate that cartilage interposition between the head of a titanium prosthesis and the tympanic membrane is not necessary to prevent extrusion.
Study Design:
Retrospective review.
Setting:
District general hospital.
Patients:
A retrospective review of 73 ears in patients aged between 5.9 and 64.5 years, which had an ossiculoplasty performed using a titanium prosthesis between the stapes footplate or stapes head and the tympanic membrane.
Interventions:
Use of Spiggle and Theis two part, shortenable titanium PORP and TORP and Grace Alto titanium TORP and PORP.
Main Outcome Measures:
Number of extruded prostheses. Audiometric results.
Results:
Five extrusions occurred in 4 patients, follow-up between 6 and 98 months. Extrusions were related to retraction of the tympanic membrane around the prosthesis. Audiometric results compared favorably with other ossiculoplasty techniques.
Conclusion:
The titanium head of the Spiggle and Theis and Grace Alto titanium prostheses interact well with the undersurface of the tympanic membrane in patients with favorable middle ear conditions. In our experience, cartilage interposition is not mandatory.
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