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Related Concept Videos

The Auditory Ossicles01:11

The Auditory Ossicles

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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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Hearing01:31

Hearing

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When we hear a sound, our nervous system is detecting sound waves—pressure waves of mechanical energy traveling through a medium. The frequency of the wave is perceived as pitch, while the amplitude is perceived as loudness.
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Related Experiment Video

Updated: Nov 18, 2025

Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
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Hearing Outcomes With a Novel Total Ossicular Replacement Prosthesis.

Kenny F Lin1, Dennis I Bojrab1, Christian G Fritz1,2

  • 1Michigan Ear Institute, Farmington Hills.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|February 8, 2021
PubMed
Summary

The Wildcat total ossicular replacement prosthesis (TORP) offers improved ease-of-use and stability for ossicular chain reconstruction. This study shows comparable hearing outcomes to existing TORPs, demonstrating its versatility in challenging cases.

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • A total ossicular replacement prosthesis (TORP) is crucial for reconstructing the ossicular chain when the stapes suprastructure is absent.
  • The Wildcat prosthesis is a novel TORP designed to simplify the procedure by integrating the footplate shoe, aiming for enhanced ease-of-use and stability.

Purpose of the Study:

  • To evaluate the hearing outcomes and stability of the Wildcat prosthesis in patients undergoing total ossicular chain reconstruction.
  • To compare the efficacy of the Wildcat prosthesis with existing TORPs in challenging cases.

Main Methods:

  • A retrospective chart review of 64 patients who received the Wildcat TORP for ossicular chain reconstruction.
  • Assessment of hearing outcomes included air and bone conduction pure-tone averages, air-bone gap (ABG), speech recognition threshold, and word recognition scores.
  • Long-term follow-up was conducted to evaluate the stability of hearing outcomes.

Main Results:

  • Significant improvement in air-bone gap (ABG) from 31.0 dB preoperatively to 22.5 dB postoperatively (p < 0.001), with 51.6% of patients achieving an ABG < 20 dB.
  • No significant differences in primary outcomes were observed based on initial vs. revision surgery, cartilage graft use, or mastoidectomy type, except for a smaller ABG reduction in canal wall down mastoidectomies.
  • Canal wall up mastoidectomies showed a greater ABG closure (13.7 dB) compared to canal wall down (4.2 dB) (p=0.039).

Conclusions:

  • The Wildcat total ossicular replacement prosthesis (TORP) provides effective hearing reconstruction, demonstrating versatility in complex cases.
  • Hearing outcomes achieved with the Wildcat prosthesis are comparable to those reported for other TORPs, suggesting its utility in neurotology practice.