A new prosthesis for reconstructing the incudostapedial joint

Area of Science:

• Otolaryngology
• Audiology
• Biomedical Engineering

Background:

• Chronic ear disease often leads to incus erosion, necessitating ossicular reconstruction.
• Ossicular reconstruction aims to restore the continuity of the middle ear chain for improved hearing.
• The Silverstein Incus-Stapes Connection is a prosthesis designed for incus reconstruction.

Purpose of the Study:

• To evaluate hearing results after using the Silverstein Incus-Stapes Connection for ossicular reconstruction.
• To compare outcomes with a control group not using prostheses.
• To assess the efficacy of the prosthesis in cases of incus resorption.

Main Methods:

• Retrospective review of 47 patients undergoing ossicular reconstruction with the Silverstein Incus-Stapes Connection.
• Comparison with 38 control patients who had similar surgery without prostheses.
• Evaluation of preoperative and postoperative air-bone gaps according to established guidelines.

Main Results:

• The mean postoperative air-bone gap was 17.6 dB with the prosthesis versus 11.8 dB in controls.
• Specific applications yielded improved air-bone gaps: 16.5 dB for lenticular resorption, 14.3 dB for larger defects with composite prostheses, and 9 dB when used as a partial ossicular replacement prosthesis.
• The prosthesis demonstrated stability and ease of intraoperative modification with cartilage.

Conclusions:

• The Silverstein Incus-Stapes Connection is a viable option for middle ear reconstruction, particularly for bridging incus resorption.
• The prosthesis offers flexibility through easy modification with cartilage for various defect sizes.
• This device can effectively restore hearing in selected patients with chronic ear disease.