[Resorbable, porous tricalcium phosphate ceramic in middle ear surgery. Initial clinical results]

In our experimental study in the pig we could demonstrate that resorbable, porous tricalcium phosphate ceramic material is suitable for an obliteration of mastoid cavities (respectively the hypotympanon of the pig) or for the reconstruction of bony wall. To examine this material in a clinical study for middle-ear surgery, we chose 2 mm thick ceramic plates and segments of truncated cones. With the aid of a diamond drill and irrigation this ceramic can be treated easily. In 25 middle ears, the following reconstructive surgeries were performed with these ceramic implants: in 22 cases a partial replacement of the lateral attic wall, in one case a replacement of the total lateral attic wall, in one case a reconstruction of the canal wall after radical mastoidectomy, and in one case an obliteration of the mastoid cavity. These 25 ears have been followed up for 2-11 months with an average of 7,1 months. In 19 cases the implants showed no sign of any complication. In four cases, however, a dehiscence of the skinny covering (outer ear canal) was observed during the post-operative healing period. In one case this dehiscence closed spontaneously, in the other case we recovered the implant by surgery. In one patient we had to remove the implant, in another one the implant is uncovered and still under observation. An inflammation of the implant bed occurred once. One implant sank down into the middle ear cavity.