Autologous total ossicular replacement prosthesis.

Area of Science:

• Otolaryngology
• Biomaterials Science
• Regenerative Medicine

Background:

• Chronic otitis media often leads to ossicular chain discontinuity, impacting hearing.
• Reconstruction of the ossicular chain is crucial for restoring auditory function.
• Existing prostheses may have limitations in biocompatibility or long-term stability.

Purpose of the Study:

• To develop and evaluate an autologous total ossicular replacement prosthesis.
• To achieve sustainable hearing results in patients with chronic otitis media.
• To assess the biocompatibility, stability, and imaging compatibility of the prosthesis.

Main Methods:

• The study involved 40 patients with chronic otitis media and absent stapes superstructure/long process of the incus.
• An autologous total ossicular replacement technique was employed for surgical repair.
• Post-operative hearing was evaluated at 6 and 12 months using pure tone air conduction and air-bone gap measurements.

Main Results:

• Successful hearing rehabilitation (pure tone average ≤ 30 dB) was achieved in 75% of patients.
• An air-bone gap of ≤ 20 dB was attained in 82.5% of patients.
• Mean air-bone gap improvement was 23.9 dB (p < 0.001), with greater improvement in tympanoplasty-only and intact canal wall groups.

Conclusions:

• The developed autologous total ossicular replacement prosthesis is biocompatible, stable, and MRI compatible.
• This technique provides sustainable hearing improvement for patients with chronic otitis media.
• The prosthesis represents a significant advancement in ossicular reconstruction.