Bone Cements as Adjuvant Techniques for Ossicular Chain Reconstruction

Hoffmann, Karen K.; Kuhn, Jeffery J.; Strasnick, Barry

doi:10.1097/00129492-200301000-00006

Cited by 30 publications

(36 citation statements)

References 10 publications

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“…PORPs and total ossicular replacement prostheses (TORPs) have the advantage of being readily available, but extrusion and stability problems (with or without displacement) are deWnite disadvantages, particularly in unstable or not well-aerated middle ears. In patients requiring revision PORP/TORP ossiculoplasty, half of the failures are indeed due to prosthesis displacement [1,7]. The risk of extrusions is much higher in inXamed and atelectatic ears [9,11].…”

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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“…Dost et al found new bone formation surrounding Bioverit Õ I þ II, hydroxyapatite and Ceravital Õ implants, and also in contact with the middle ear wall in guinea pigs [18,19,23]. Additionally, a significant amount of new bone around the ossicle was observed in a reconstruction with hydroxyapatite cement and dahllite cement [24]. This fact leads to the conclusion that the extensive ossification limits the use of guinea pigs for research about ossicular chain replacements [18].…”

Section: Animal Modelmentioning

confidence: 99%

Free Bioverit ^® II Implants Coated with a Nanoporous Silica Layer in a Mouse Ear Model — A Histological Study

et al. 2008

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The objective of this study is to evaluate the suitability of a mouse middle ear model for testing ossicular replacement materials. Twenty-four BALB/c mice are implanted with the bioglass-ceramic Bioverit Õ II which is coated with a silica-nanostructure or with plain Bioverit Õ II as a control. After 2, 6, and 12 weeks, 4 mice per group are sacrificed and both complete petrous bones are analyzed histologically. All implants revealed in situ an incipient growth of thin connective tissue layers over the surface, followed by a *Author to whom correspondence should be addressed. E-mail: Brandes.gudrun@mh-hannover.de spreading of epithelial cells. The osseogenic response which is increasing with time is more intense in the coated Bioverit Õ II specimens. The absence of inflammatory cells suggests an excellent biocompatibility of the silica nano structure. As the results are comparable to a study with the same materials in rabbits, the mouse model described is highly suitable for evaluation of new ossicular replacement materials. Additionally, by gene expression analysis a more detailed insight into cellular interactions of the middle ear is offered.

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“…Subsequently, in half of the patients requiring revision ossiculoplasty due to poor hearing results, prosthesis displacement is the cause for failure. Other reasons are extrusion and absorption of the biomaterial [6].…”

Section: Indications For Ossicular Chain Reconstructionmentioning

confidence: 99%

“…Reports on successful implantation in unsterile sites like the paranasal sinuses for sinus lift in dentistry and sinus obliteration in rhinology [25,26] makes the use for ossicular chain reconstruction considerable. Recent in vivo animal studies showed evidence of osseointegration with ossicular bone [6].…”

Section: Hydroxyapatitementioning

confidence: 99%

Biomaterials for ossicular chain reconstruction. A review

Neumann

Jahnke

2003

Materialwissenschaft Werkst

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This review gives a survey of biomaterials used for ossicular chain reconstruction. The survey is focussed on application, biophysical requirements, properties and goals for future developments. The implantation site middle ear differs from others due to aeration and potential bacterial colonization. As a consequence, implant materials must exhibit excellent biocompatibility, biostabilty and sound conducting properties. In vitro and in vivo biocompatibility investigations and clinical observations determine the choice of material. Additionally the implants must provide the possibilty of intraoperative shaping or should be available in different variations in order to allow reconstruction appropriate to the individual conditions. Ceramics, metals and plastics are materials in current use. Based on thorough experimental and long term clinical experiences, the bioinert aluminum oxide is favorable amoung the ceramics. Bioactive ceramics may have minor biostability and the risk of fixation to surrounding bone which impairs sound conduction. This is also true for hydroxyapatite although biodegradation occurs only rarely. Today, titanium is the metal best established in middle ear implantation, reflected by excellent biocompatibility in vitro and in vivo, and good clinical results. Titanium is preferred by many surgeons, considering that sound transmission properties are mainly dependent on the implant weight. In stapes surgery, when the implant has direct contact to inner fluids, gold was accused to cause granuloma formation with subsequent inner ear damage in selected cases. In frequent past and present use, plastics (porous polyethylene and teflon) have proven to be of limited value in ossicular chain replacement because of high extrusion rates and the observation of material desintegration and bacterial colonization. In order to individually manage the pathological conditions in the middle ear, the implant design is of crucial importance. It is dependent on the ossicle to be replaced and the implant material. Future investigations have to minimize implant extrusions possibly by modifying and improving implant surfaces.

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Bone Cements as Adjuvant Techniques for Ossicular Chain Reconstruction

Cited by 30 publications

References 10 publications

Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling

Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling

Free Bioverit ^® II Implants Coated with a Nanoporous Silica Layer in a Mouse Ear Model — A Histological Study

Biomaterials for ossicular chain reconstruction. A review

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Bone Cements as Adjuvant Techniques for Ossicular Chain Reconstruction

Cited by 30 publications

References 10 publications

Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling

Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling

Free Bioverit ® II Implants Coated with a Nanoporous Silica Layer in a Mouse Ear Model — A Histological Study

Biomaterials for ossicular chain reconstruction. A review

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Free Bioverit ^® II Implants Coated with a Nanoporous Silica Layer in a Mouse Ear Model — A Histological Study