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Related Concept Videos

The Auditory Ossicles01:11

The Auditory Ossicles

3.8K
The auditory ossicles of the middle ear transmit sounds from the air as vibrations to the fluid-filled cochlea. The auditory ossicles consist of two malleus (hammer) bones, two incus (anvil) bones, and two stapes (stirrups), one on each side. These bones develop during the fetal stage and are the ones to ossify first. They are fully mature at birth and do not grow afterward.
The aptly named stapes look very much like a stirrup. The three ossicles are unique to mammals, and each plays a role in...
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Related Experiment Video

Updated: Apr 25, 2026

Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
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Pediatric ossiculoplasty with titanium total ossicular replacement prosthesis.

Nikolaus E Wolter1, Theresa Holler, Sharon L Cushing

  • 1Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario.

The Laryngoscope
|August 27, 2014
PubMed
Summary

Titanium total ossicular replacement prostheses (TORPs) provide effective hearing restoration in children. However, hearing gains may decrease over time, necessitating monitoring and potential revision surgery.

Keywords:
Ossicular reconstructioncholesteatomahearing losspediatrictitanium prosthesis

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Area of Science:

  • Otolaryngology
  • Audiology
  • Biomaterials in reconstructive surgery

Background:

  • Ossicular reconstruction is crucial for hearing restoration in children with middle ear defects.
  • Titanium total ossicular replacement prostheses (TORPs) are utilized for this purpose.

Purpose of the Study:

  • To evaluate the medium-term effectiveness of titanium TORPs in pediatric patients undergoing ossicular reconstruction.
  • To assess hearing outcomes and prosthesis durability over time.

Main Methods:

  • A case series of children (aged 7-18) receiving titanium TORPs was analyzed.
  • Audiometric testing (air and bone conduction, air-bone gap) was performed preoperatively and at regular intervals postoperatively.
  • Kaplan-Meier analysis assessed the proportion of successful outcomes (≤30 dB HL AC).

Main Results:

  • 75 TORPs were implanted in 71 children with a median follow-up of 2.7 years.
  • At 1 year, mean AC PTA was 35 dB HL and ABG was 29 dB, with 14 dB ABG closure.
  • 50% achieved successful hearing outcomes initially; however, 10% experienced deterioration by 1-3 years. Four revisions were performed.

Conclusions:

  • Titanium TORPs are an effective option for pediatric ossicular reconstruction with low short-term extrusion rates.
  • Initial hearing improvements are generally maintained through the first year but may decline in subsequent years.