Applicability of autologous incus: the influence of age and localization of cholesteatoma

Stanković, Milan

doi:10.1007/s00405-007-0293-1

Cited by 9 publications

(3 citation statements)

References 17 publications

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“…In ossicles of grade 3 it has been found up to four layers of epithelial cells on the surface of the ossicles. These observations (Stage III) are in agreement with other studies [1,2,13,14].…”

Section: Discussionsupporting

confidence: 93%

Ossicles Autograft Safety in Cholesteatoma: A Histological Study

Attanasio¹,

Cl²,

Covelli³

et al. 2013

J Cytol Histol

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Objective: The aim of the study is to define, just before any sort of cleaning procedure, if there is any epithelial inclusion inside the ossicles of patients with cholesteatoma and if the findings could be correlated with surgical aspect of cholesteatoma. Methods: The specimens used for this study were 19 malleus and 15 incuss which were intraoperatively obtained from 24 patients. Each ossicles was grouped on the basis of cholesteatoma intraoperatively aspect as follows: Stage 1: ten ossicles obtained from encapsulated cholestatoma, non-invasive, easily cleavable. Stage 2: fourteen ossicles obtained from partially encapsulated cholesteatoma, non-invasive, non-easily cleavable. Stage 3: ten ossicles obtained from not encapsulated cholesteatoma, invasive, not cleavable. Two stapes and 1 malleus have been taken from patients who underwent middle ear surgery for conductive hearing loss and they have been used as control. The ossicles were examined histopathologically after the removal. Results: Our results do not show any epithelial inclusion inside the ossicles independently from the macroscopic aspect or growing aggressiveness of cholesteatoma. In addition there was not inflammatory cells infiltration in stage 1, but it was present in one incus (7.1%) of stage 2 and in five ossicles (50%) of stage 3. In ossicles of grade 3 it has been found up to four layers of epithelial cells on the surface of the ossicles. Conclusion: The results of the present study reject the hypothesis that epithelial inclusions into the ossicles could cause cholesteatoma recurrences, but strongly suggest to perform safe cleaning procedure of ossicular remnants to make them usable in ossiculoplasty in patient with partially or not encapsulated cholesteatoma.

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Section: Discussionsupporting

confidence: 93%

Ossicles Autograft Safety in Cholesteatoma: A Histological Study

Attanasio¹,

Cl²,

Covelli³

et al. 2013

J Cytol Histol

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“…3 wiedergegeben. [30]. Der Knochen der zurechtgeschliffenen Ossikelprothesen wird über die Jahre überwiegend durch Osteoneogenese ersetzt [31].…”

Section: Akustisch-mechanische Anforderungenunclassified

Passive und aktive Mittelohrimplantate

Beutner

Hüttenbrink

2009

Laryngo-Rhino-Otol

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Besides eradication of chronic middle ear disease, the reconstruction of the sound conduction apparatus is a major goal of modern ear microsurgery. The material of choice in cases of partial ossicular replacement prosthesis is the autogenous ossicle. In the event of more extensive destruction of the ossicular chain diverse alloplastic materials, e. g. metals, ceramics, plastics or composits are used for total reconstruction. Their specialised role in conducting sound energy within a half-open implant bed sets high demands on the biocompatibility as well as the acoustic-mechanic properties of the prosthesis. Recently, sophisticated titanium middle ear implants allowing individual adaptation to anatomical variations are widely used for this procedure. However, despite modern developments, hearing restoration with passive implants often faces its limitations due to tubal-middle-ear dysfunction. Here, implantable hearing aids, successfully used in cases of sensorineural hearing loss, offer a promising alternative. This article reviews the actual state of affairs of passive and active middle ear implants.

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“…As a relatively low impedance material, cartilage is, from an acoustic point of view, only to be used for reconstruction of the tympanic membrane, and not for procedures in the ossicular chain, since due to resorption processes with consecutive chondromalacia [28], dimensional stability decreases. Autogenous ossicular residue, incus body or malleus head, on the other hand, are regarded as the golden standard for chain reconstruction [29], if an attached cholesteatom matrix, an ostitis or extensive destruction do not suggest that they are unsuitable for reuse [30]. The bone of the fitted ossicle prosthesis is replaced over the years mainly by osteoneogenesis [31].…”

Section: Passive Middle Ear Implantsmentioning

confidence: 99%