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Titanium Prostheses for Treating Posttraumatic Ossicular Chain Disruption.

Lukasz Plichta1, Aleksandra Dabkowska1, Sandra Wawszczyk-Frohlich1

  • 1Oto-Rhino-Laryngology Surgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland.

The Journal of International Advanced Otology
|September 5, 2022
PubMed
Summary

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Titanium prostheses effectively reconstruct the ossicular chain following traumatic disruption, significantly improving hearing thresholds and air-bone gaps. This surgical option offers satisfactory audiological outcomes for patients with persistent conductive hearing loss.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Audiology

Background:

  • Posttraumatic ossicular chain disruption can result from head trauma, barotrauma, or foreign bodies.
  • Severe incus damage or absence necessitates ossicular chain reconstruction.
  • Titanium prostheses offer a viable solution for restoring the ossicular chain.

Purpose of the Study:

  • To evaluate the audiological outcomes of titanium ossicular replacement prostheses in posttraumatic ossicular chain disruption.
  • To assess the effectiveness of partial or total ossicular replacement prostheses in improving hearing thresholds.

Main Methods:

  • Retrospective analysis of 24 cases treated with titanium partial or total ossicular replacement prostheses.
  • Measurement of air conduction, bone conduction, and air-bone gap preoperatively and at 6-12 months and over 2 years postoperatively.

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  • Calculation of hearing thresholds based on the mean of four frequencies (0.5, 1, 2, and 4 kHz).
  • Main Results:

    • Blunt head trauma from traffic accidents was the most common cause (9/24 cases).
    • Significant improvement in average air conduction thresholds and air-bone gap was observed post-surgery (P < .05).
    • 67% of patients achieved an air-bone gap closure within 20 dB.

    Conclusions:

    • Posttraumatic ossicular chain disruption, while uncommon, should be suspected in persistent conductive hearing loss after injury.
    • Ossiculoplasty using titanium prostheses yields satisfactory audiological results.
    • Titanium partial or total ossicular replacement prostheses are effective for reconstructing the damaged ossicular chain.