Literature review of alloplastic materials in ossiculoplasty

Ossiculoplasty

“…He used a vinyl-acryl plastic called palavit as a prosthesis placed between the tympanic membrane graft and the stapes footplate. Since that time, numerous materials, including polyethylene, polytetrafluoroethylene, silicone, stainless steel, proplast, plastipore, ceravital, bioglass, aluminum oxide ceramic, hydroxylapatite, carbon, titanium, platinum, tantalum, and gold, have been reported and most largely abandoned [9,10]. A survey of otologists and neurotologists conducted by Goldenberg and Emmet [11] in 1999 shows an interesting shift in the use of prostheses for ossiculoplasty.…”

“…Polyethylene 90 tubing used in reconstruction in the late 1950s to early 1960s had some good initial results; however, this material was noted to induce an inflammatory reaction in animal studies [23,24]. Additionally, plastipore implants were criticized by some owing to studies that show frequent histologic evidence of multinucleated giant cells on plastipore implants, even though there has not been a clear association delineated between the presence of these cells and a foreign body reaction [9,25]. Ceravital was a bioceramic first introduced in the early 1980s with promising hearing results and low extrusion rates.…”

“…Retraction of the eardrum from negative pressure, fluid or granulation tissue in the middle ear, and scarring with tethering of the tympanic membrane, prosthesis, or remaining ossicles can all be detrimental to efficient middle ear impedance matching function. In fact, it is likely that pathology in the middle ear is more significant than prosthetic factors when considering extrusions and reconstruction failure [9,28]. During healing, scar formation and resultant tethering of the prosthesis, tympanic membrane, remaining ossicles, or footplate can undo any acoustic gain garnered from ossiculoplasty.…”

“…To make these HA implants easier to manipulate and cut for sizing, numerous hybrid implants were developed with heads made of HA and shafts made of various materials including plastipore, polycel, polytetrafluoroethylene, FLEX HA (50% HA and 50% SilasticÒ [Dow Corning, Midland, Michigan]), and HAPEX (HA reinforced polyethylene composite) [9,11,28,30,39]. Long-term extrusion rates for HA are not reported frequently, but the few reports that exist place the rate at 4% to 16% [40,41].…”

A comparative study of surgical outcomes of ossiculoplasty using biomaterials and autologous implants

“…The acceptability and extrusion rates in these materials were ranged from as low as 1.3% to 30% 15,16 . In the present study, the overall extrusion rate is 8.7% and both autografts and biomaterials behave equally well in ossiculoplasty 17,18 .…”