Hearing results with the titanium ossicular replacement prostheses

Abstract

The purpose was to study the hearing results in patients receiving a Kurz titanium Bell partial ossicular replacement prosthesis (PORP) or an Aerial total ossicular replacement prosthesis (TORP). The study was a retrospective chart review in a tertiary otologic referral center. A computerized otologic database was used to identify 111 patients implanted with either a PORP or TORP prosthesis. Audiograms were reviewed and air-bone gaps were calculated for each patient. The improvement of the average air-bone gap (ABG) was 10.2 and 12.7 dB at 3 and 20 months after ossiculoplasty, respectively. Sixty-six percent of patients (73/111) had a postoperative air-bone gap of 20 dB or less. The ABG for the titanium PORP prosthesis was 14.3+/-9.7 dB, compared with 25.2+/-13.7 dB for the TORP prosthesis (P <0.05). The ABG to within 20 dB or less was obtained in the PORP group in 77% of the cases, versus 52% of the cases in the TORP group (P <0.05). Two extrusions of the prostheses were observed at 17 and 20 months after surgery (1.8%). Revision procedures for functional failure were carried out in 20 patients (18%). The rate of sensorineural hearing loss was 3.6%. The major factors influencing good audiometric results were the surgical procedure preserving the external auditory canal and the presence of the stapes. The best hearing results were achieved when a PORP was used in an intact canal wall (ICW) procedure, and the worst hearing results were achieved when a TORP was used in a canal wall down (CWD) procedure. The titanium Kurz prosthesis has been an effective implant at our institution for ossicular reconstruction.

Long term results of ossiculoplasties with partial and total titanium Vario Kurz prostheses in children

“…A wide range of values of ABG improvement with various types of PORP and TORP has been reported. Concerning titanium prosthesis, although most studies report that PORP outperform TORP [2][3][4]16], some series [1,14,17] report no significant difference between both types of reconstruction or even better results with TORP [12]. This suggests that the quality of mechanical coupling between TORP titanium prosthesis and the footplate is adequate.…”

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

“…The success rates of other otologic surgeons who used the same implants were for House and Teufert [12] 61 and 69% for TORP and PORP, respectively, and for Slater et al [13] they were 69 and 45%, respectively. Schmerber et al [14] , using titanium ossicular replacement prostheses, found ABG closure to within 20 dB or less in 77% of the cases in the PORP group, versus 52% of the cases in the TORP group. In a recent, very informative study, Truy et al [15] reported similar ABG values in four subgroups (TORP vs. PORP and hydroxyapatite vs. titanium).…”

Hearing results using titanium ossicular replacement prosthesis in intact canal wall tympanoplasty for cholesteatoma

“…Several authors have reported high biocompatibility of these implants, with extrusion rates lower than 5% and good hearing results, and with average postoperative air-bone gap (ABG) ranging from 14 to 21 dB and postoperative ABG lower than 20 dB in 56-77% of cases [4][5][6][7][8][9][10][11]. The described advantages of titanium over other materials are its tensile strength, light weight and mass, and biocompatibility [3][4][5][6].…”