Total artificial middle ear: preliminary report

Reconstruction of a totally empty middle ear is difficult. This study reports results of 15 patients implanted with a total artificial middle ear developed on the principles of a total homologous middle ear and consisting of a canal wall prosthesis, a tympanic membrane/malleus prosthesis, and an incus/stapes prosthesis. Satisfactory results were noted in 12 of 15 patients at 1-year follow-up, with air-bone gap closure within 30 dB; within 20 dB in seven of these twelve. However, at 3-year follow-up examination the total artificial middle ear was removed in seven cases due to obliteration and infection of the middle ear. These failures related to the extensive middle ear disease initially noted in these seven patients. These long-term results indicate the necessity of careful patient selection for reconstruction.