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Total artificial middle ear: preliminary report

J J Grote1

  • 1Department of Otolaryngology, University Hospital Leiden, The Netherlands.

The American Journal of Otology
|November 1, 1995
PubMed
Summary
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This study evaluated a total artificial middle ear prosthesis in 15 patients. While initial results were promising, long-term follow-up showed a high failure rate due to infection and obliteration, highlighting the need for careful patient selection.

Area of Science:

  • Otolaryngology
  • Biomedical Engineering
  • Surgical Reconstruction

Background:

  • Reconstructing a completely empty middle ear presents significant surgical challenges.
  • Traditional methods for middle ear reconstruction have limitations in severe cases.

Purpose of the Study:

  • To evaluate the efficacy and long-term outcomes of a novel total artificial middle ear prosthesis.
  • To assess the safety and audiological results of this innovative reconstruction technique.

Main Methods:

  • Fifteen patients with totally empty middle ears were implanted with a total artificial middle ear prosthesis.
  • The prosthesis comprised a canal wall, tympanic membrane/malleus, and incus/stapes component.
  • Audiological outcomes, specifically air-bone gap closure, were assessed at 1 and 3 years post-implantation.

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Main Results:

  • Satisfactory audiological results (air-bone gap closure ≤30 dB) were achieved in 12 out of 15 patients at 1-year follow-up.
  • Seven of these patients demonstrated excellent results (air-bone gap closure ≤20 dB).
  • However, by the 3-year follow-up, seven prostheses were removed due to middle ear obliteration and infection, particularly in patients with pre-existing extensive disease.

Conclusions:

  • Total artificial middle ear prostheses can provide initial audiological benefits.
  • Long-term success is significantly impacted by the extent of pre-existing middle ear disease.
  • Careful patient selection is crucial to mitigate risks of infection and obliteration for successful reconstruction.