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Gold prostheses for ossiculoplasty
1Department of Otorhinolaryngology, University of Erlangen-Nuremburg, Erlangen, Germany.
Objective:
To review the results of ossicular chain reconstruction with partial and total ossicular replacement prostheses made of gold.
Study Design:
Retrospective case review.
Setting:
A tertiary referral center.
Patients:
Fifty-nine patients underwent surgery between November 1993 and February 1996 and underwent follow-up for at least 12 months. Tympanoplasty was performed because of cholesteatoma, chronic otitis media, adhesive otitis media, and trauma.
Intervention:
Tympanoplasty and ossiculoplasty with partial or total replacement gold prostheses.
Main Outcome Measure:
The clinical and hearing results of ossiculoplasty.
Results:
In 62% of the patients in whom partial ossicular replacement prostheses were used, the residual air-bone gap could be reduced to < or =20 dB. In cases with total ossicular replacement prostheses, the air-bone gap could be closed to < or =20 dB in 42%. Extrusion of the prosthesis occurred in 11 cases (19%) between 7 and 21 months after tympanoplasty. In most extrusion cases (55%), this was combined with a significant retraction of the tympanic membrane. Primary and staged procedures showed different extrusion rates.
Conclusions:
Hearing results in the current study are comparable to results described by other authors for synthetic middle ear prostheses. Implant rejection was never encountered, with the gold implants exhibiting a high biocompatibility. Nevertheless, prosthesis extrusion occurred rather often in the course of tympanic membrane retraction. Staging the surgery or different shaping of the prosthesis may be helpful to prevent prosthesis extrusion.