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Fate of middle ear implants
S B Ogale1, S B Mahajan, S Dutt
1Department of E.N.T., Seth G.S. Medical College, Parel, Bombay, India.
Auris, Nasus, Larynx
|April 1, 1997
Summary
This study compared graft materials for ossicular chain reconstruction, finding natural options like autologous and homologous ossicles offer superior long-term acceptance and lower extrusion rates in ear surgery.
Area of Science:
- Otolaryngology
- Biomaterials Science
- Surgical Outcomes Research
Background:
- Ossicular chain reconstruction is a critical surgical procedure for hearing restoration.
- A variety of graft materials have been employed, each with varying success rates.
- Understanding graft material performance is essential for optimizing surgical outcomes in chronic otitis media and cholesteatoma cases.
Purpose of the Study:
- To evaluate and compare the extrusion rates of different graft materials used in ossicular chain reconstruction.
- To determine the long-term acceptance and efficacy of natural versus synthetic graft materials.
- To provide evidence-based insights for surgeons selecting graft materials for ear operations.
Main Methods:
- A retrospective analysis of 613 ear operations requiring ossicular chain reconstruction (excluding stapedectomy) between 1981 and 1993.
- Categorization of cases into cholesteatomatous (371 cases) and safe chronic otitis media.
- Comparison of extrusion rates for various graft materials: autologous ossicles, tragal cartilage, homologous ossicles, cortical bone, human dentine, cadaveric styloid process, and gold prosthesis.
Main Results:
- Extrusion rates varied significantly by graft material: autologous ossicles (1.54%), homologous ossicles (1.43%), tragal cartilage (1.19%), cadaveric costal cartilage (3.61%), cadaveric styloid process (5.45%), dentine (7.14%), and gold prosthesis (8.70%).
- Natural graft materials, specifically autologous and homologous ossicles, demonstrated favorable outcomes.
- Results were found to be comparable to findings in other relevant studies.
Conclusions:
- Natural graft materials, including autologous and homologous ossicles, exhibit superior take-up rates and long-term acceptance in ossicular chain reconstruction.
- Tragal cartilage also presents a low extrusion rate, making it a viable option.
- The choice of graft material significantly impacts the success and longevity of hearing restoration in ear surgery.