[Aluminum oxide ceramic implants (Tübigen type) in middle ear surgery. Report of clinical experiences]

Since 1980 we have used Tübingen middle ear implants of aluminum oxide in some reconstructions of the ossicular chain. So far such implants have been inserted in 129 operations on 106 patients. Follow-up examinations have been performed on 108 ears (91 patients). Post-operative observation periods have varied from 6 to 46 months, with an average duration of 22 months. In the last two years, since observing the first extrusions and imminent extrusions of implants, we have begun inserting a small autologous cartilage-perichondrium disk between implant and eardrum. Follow-up examinations have shown that insertion of cartilage lowers the rates of extrusion and imminent extrusion. It should be noted, however, that the average observation period for implants with cartilage has been somewhat shorter than for those without cartilage. Good audiometric results have been obtained with Al2O3-ceramic implants. Moreover, insertion of a cartilage-perichondrium disk demonstrably contributes to an improvement of audiometric results. As our clinical study shows, an Al2O3-ceramic implant is quite suitable for reconstructive surgery of the ossicular chain when an alloplastic implant is needed. At the same time we strongly advise insertion of a cartilage-perichondrium disk between the eardrum and the implant.