Bone Cement Reconstruction of the Ossicular Chain: A Preliminary Report

Feghali, Joseph G.; Barrs, David M.; Beatty, Charles W.; Chen, Douglas A.; Green, J. Douglas; Krueger, Wesley W. O.; Shelton, Clough; Slattery, William H.; Thedinger, Bradley S.; Wilson, David F.; McElveen, John T.

doi:10.1097/00005537-199806000-00010

Cited by 35 publications

(32 citation statements)

References 13 publications

(13 reference statements)

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“…The use of biocements is the latest innovation in the reconstruction of the ossicular chain and seems promising [7,8,[12][13][14]. Bone cements have been extensively used as prosthetic material in craniofacial surgery, and their adhesive and osseointegrative properties make them ideal for use in ossicular chain reconstruction [7,8].…”

Section: Discussionmentioning

confidence: 99%

Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling

Somers¹,

Rompaey²,

Claes³

et al. 2011

Eur Arch Otorhinolaryngol

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The objective of this study was to compare the hearing outcome using hydroxyapatite (HA) bone cement to bridge the incudostapedial gap versus incus remodelling for ossiculoplasty in case of incudostapedial discontinuity. A non-randomized retrospective study was conducted at a tertiary referral otologic centre. The intervention in 24 primary cases of conductive hearing loss was subsequent middle ear inspection where incudostapedial discontinuity was observed. HA bone cement was used in 10 consecutive cases, and incus remodelling was performed in 14 consecutive cases. Air-bone gap (ABG), bone-conduction (BC) thresholds, and air-conduction (AC) thresholds were evaluated preoperatively and at 3, 6 and 12 months postoperatively. No patients were lost to follow-up. Pure-tone averages were calculated according to the guidelines of the Committee on Hearing and Equilibrium for the evaluation of conductive hearing loss. The Amsterdam Hearing Evaluation Plots are presented. The postoperative ABG closure to within 20 and 10 dB at 12 months was, respectively, 80 and 40% in the HA bone cement group and 57.1 and 28.6% in the standard ossiculoplasty group (no statistically significant difference). However, we observed a statistically significant difference in ABG gain at 6 and 12 months favoring the HA bone cement cases. No short-term or intermediate-term adverse reactions were observed. Hydroxyapatite bone cement bridging ossiculoplasty offers a better intermediate-term ABG gain than standard ossiculoplasty. This new technique is a valuable alternative to conventional ossiculoplasty and presents the practical advantage of being easier and faster.

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Section: Discussionmentioning

confidence: 99%

Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling

Somers¹,

Rompaey²,

Claes³

et al. 2011

Eur Arch Otorhinolaryngol

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“…Instead of the development of new implant materials, there are few ossicular prostheses that can approximate the acoustic efficiency of the normal ossicular chain. Ossiculoplasty using either a partial or a total replacement prosthesis (PORP or TORP) is considered successful if the residual conductive deficit is less than 15 dB for a PORP and less than 25 dB for a TORP [10] . Brackmann et al [11] present a closure of the ABG of 15 dB for PORP and 25 dB for TORP.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of Plastipore Prostheses in Reconstruction of the Middle Ear Ossicular Chain

Eleftheriadou

Chalastras²,

Georgopoulos³

et al. 2009

ORL

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Purpose: To examine the acoustic results over a long period of time, in patients who underwent ossiculoplasty with Plastipore, and to report the percentage of prosthesis extrusion and factors related to the prognosis. Procedures: Forty-two patients, who underwent ossiculoplasty with Plastipore, were studied. Patients were followed up for the next 14 years. The surgical procedures were classified as: tympanoplasty, tympanoplasty with mastoidectomy with canal wall up, and tympanoplasty with mastoidectomy with canal wall down. A successful hearing result was defined as a postoperative air-bone gap (ABG) of 20 dB or less. Results: Successful results were seen in 65% of our patients, 68.8% with a partial ossicular replacement prosthesis (PORP) and a 62.5% success rate with a total ossicular replacement prosthesis (TORP). The mean value for ABG improvement was 25.5 dB. Prosthesis extrusion occurred in 4.7%. Conclusions: The ossiculoplasty-Plastipore technique leads to good hearing results and a low percentage of prosthesis extrusion in long-term follow-ups.

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“…There are a number of different types of bone cements studied for ossiculoplasty including Dahllite [50], hydroxylapatite [50][51][52][53], and glass ionomeric [54,55]. Glass ionomeric preparations (eg, OtoCem; Oto-Tech, Raleigh, North Carolina) may provide good initial hearing results but are associated with unfavorable toxicity and biocompatibility profiles [56].…”

Section: Ha Incusmentioning

confidence: 99%

Ossiculoplasty

Javia¹,

Ruckenstein²

2006

Otolaryngologic Clinics of North America

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Contemporary surgical techniques for treating various pathologies affecting the middle ear address not only eradication of the underlying disease process but also restoration of normal auditory function. Trauma, neoplasms, inflammatory processes, and cholesteatomas can erode and alter normal middle ear components and relationships vital for the transmission of auditory energy to the inner ear. Over the last five decades, various ossiculoplasty techniques and prostheses have been studied and reported in the literature. Unfortunately, the multitude of reconstructive techniques attests to the fact that none of the currently available methods are ideal.

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Bone Cement Reconstruction of the Ossicular Chain: A Preliminary Report

Abstract: Despite the limited number of patients, this preliminary study demonstrates the effectiveness of Oto-Cem in reconstructing a foreshortened incus. There was a substantial hearing improvement in all but one patient in the incus to stapes or the incus to footplate categories.

Cited by 35 publications

References 13 publications

Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling

Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling

Long-Term Results of Plastipore Prostheses in Reconstruction of the Middle Ear Ossicular Chain

Ossiculoplasty

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