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Updated: Dec 23, 2025
Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
Published on: January 26, 2024
The Titanium Angular Clip Prosthesis for Ossicular Chain Reconstruction: Long-Term Results
Konrad Johannes Stuermer1, Karl-Bernd Hüttenbrink, Jan Christoffer Luers
1University of Cologne, Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, Cologne Germany.
Objectives:
To describe the long-term results of the titanium angular clip prosthesis 10 years after its initial description.
Study Design:
Clinical retrospective study.
Setting:
Tertiary referral center.
Patients:
Sixty three patients with isolated defects of the long process of the incus where the ossicular chain was reconstructed by a titanium angular clip prosthesis.
Interventions:
Therapeutic.
Main Outcome Measures:
The mean air-bone gap was calculated over the frequencies of 0.5, 1, 2, 3, and 4 kHz.
Results:
The placement of the prosthesis was straightforward in all patients, without any complication. During the first follow-up visit after 3 weeks (n = 61) the mean air-bone gap (ABG) was reduced by 10 dB HL, and from 24 dB HL preoperatively to 14 dB HL. At the long-term follow-up appointment-4 years after implantation (n = 29)-the mean ABG was still reduced by 8 dB HL, from a mean of 26 dB HL preoperatively to 18 dB HL.
Conclusion:
The use of the titanium angular clip prosthesis is a safe and reliable way to bridge an isolated erosion of the long process of the incus, leading to significant and long-lasting improvement of the ABG both in the short and long-term follow-up. A similarly large improvement of the sound transmission can be achieved both in patients with a Type A and a Type B/C tympanogram.
