Interposed cartilage as a precaution against extrusions of ceramic ossicular replacement implants

Since 1980 we have used middle ear implants of aluminum oxide ceramic in some reconstructions of the ossicular chain. We had opportunities to examine 108 ears (91 patients); the longest period of postoperative observation was 4 years. Follow-up examinations showed that the rates of extrusion and liability to extrusion can be reduced by interposing a small disk of autologous cartilage and perichondrium. Moreover, interposing cartilage trends to improve audiometric results. On the basis of our study, we strongly recommend the interposition of a disk of autologous cartilage and perichondrium between the middle ear implant and eardrum when an Al2O3 implant is used.