Ossiculoplasty using hydroxyapatite prostheses: long-term results

Shinohara, Takayuki; Gyo, Kiyohumi; Saiki, Tadahiko; Yanagihara, Naoaki

doi:10.1046/j.1365-2273.2000.00364.x

Cited by 52 publications

(31 citation statements)

References 8 publications

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“…For reconstruction, multiple surgeries are often necessary and results are highly variable. Some evaluations of long-term results have indicated rates of failure of up to 45-50% for passive reconstruction using various materials, including extrusion rates up to 16% [Kapur and Jayaramchandran, 1992;Shinohara et al, 2000]. Despite fairly successful ossiculoplasties, hearing loss interfering with speech intelligibility remains in a substantial number of reconstruction patients, who require hearing aids even after surgery.…”

Section: Introductionmentioning

confidence: 99%

Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results

et al. 2016

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Objective: To evaluate the safety and effectiveness of round window (RW), oval window (OW), CliP and Bell couplers for use with an active middle ear implant. Methods: This is a multicenter, long-term, prospective trial with consecutive enrollment, involving 6 university hospitals in Germany. Bone conduction, air conduction, implant-aided warble-tone thresholds and Freiburger monosyllable word recognition scores were compared with unaided preimplantation results in 28 moderate-to-profound hearing-impaired patients after 12 months of follow-up. All patients had previously undergone failed reconstruction surgeries (up to 5 or more). In a subset of patients, additional speech tests at 12 months postoperatively were used to compare the aided with the unaided condition after implantation with the processor switched off. An established quality-of-life questionnaire for hearing aids was used to determine patient satisfaction. Results: Postoperative bone conduction remained stable. Mean functional gain for all couplers was 37 dB HL (RW = 42 dB, OW = 35 dB, Bell = 38 dB, CliP = 27 dB). The mean postoperative Freiburger monosyllable score was 71% at 65 dB SPL. The postimplantation mean SRT₅₀ (speech reception in quiet for 50% understanding of words in sentences) improved on average by 23 dB over unaided testing and signal-to-noise ratios also improved in all patients. The International Outcome Inventory for Hearing Aids (IOI-HA)quality-of-life questionnaire was scored very positively by all patients. Conclusion: A significant improvement was seen with all couplers, and patients were satisfied with the device at 12 months postoperatively. These results demonstrate that an active implant is an advantage in achieving good hearing benefit in patients with prior failed reconstruction surgery.

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Section: Introductionmentioning

confidence: 99%

Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results

et al. 2016

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“…A literature search revealed that of all available materials, hydroxyapatite (HA) was the most commonly used in the last decade [2]. However, long-term studies for HA alloplasts have reported an extrusion rate of 5-15% [3,4]. Present evidence indicates that titanium has a greater ability to transmit sound than the heavier HA [5].…”

Section: Introductionmentioning

confidence: 99%

The Efficiency of Titanium Middle Ear Prosthesis in Ossicular Chain Reconstruction: Our Experience

Shah

Bradoo

Joshi

et al. 2011

Indian J Otolaryngol Head Neck Surg

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Middle ear ossicular reconstruction is a challenging task for any otologist. Over a period of time, surgeons have tried various types of materials as ossicular prosthesis with varying amount of success. In the last decade, numerous studies have been conducted that have proved that titanium prosthesis is biocompatible. We have conducted this study to investigate the efficiency of titanium middle ear prosthesis (Eon Meditech Pvt. Ltd.) in tympanoplasty. Nineteen patients who underwent tympanoplasty with titanium prosthesis placement from January to October 2010 were included in the study. Fifteen patients underwent reconstruction using titanium PORP while four patients required titanium TORP. The average follow up period was 11.1 months. The pre-operative and post-operative PTAs and the closure of the air-bone gap (ABG) at 0.5, 1, 2, 3 KHz (as per the AAO-HNS guidelines) were analyzed. As per the Indian speech and hearing association (ISHA) guidelines, the patients were classified into groups based on the amount of hearing loss. The improvement in the mean PTA (AC) was 16.21 dB in the PORP group while it was 20.47 dB in the TORP group (P value \ 0.05). According to ISHA guidelines, 18 out of 19 (94.8%) patients had either a normal hearing or a mild hearing loss post-operatively. The overall success rate (post-operative ABG B 20 dB) of this series is 68.4%. In this series, there has been no extrusion of the prosthesis. Titanium prosthesis is delicate, easy and quick to handle. They are efficient and suitable implants for middle ear ossicular reconstruction. The use of cartilage between the prosthesis and the graft helps to prevent extrusion of the prosthesis.

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“…Though a disk of cartilage between the head of prosthesis and tympanic membrane has reduced the risk of extrusion, cartilage disk did not eliminate it entirely [7]. Hydroxyapatite has been more successful as regards to functional hearing but extrusion rates remain high when used as TM-footplate assembly [8,9].…”

Section: Introductionmentioning

confidence: 99%

Use of autogenic and allogenic malleus in tympanic membrane to footplate assembly — long-term results

Mahadevaiah¹,

Parikh²

2009

Indian J Otolaryngol Head Neck Surg

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The objective of this study was to assess the functional performance and long-term stability of autogenic and allogenic malleus used for ossiculoplasty as tympanic membrane to footplate assembly. A retrospective study of 119 patients who underwent such ossiculoplasty in closed cavity mastoidectomy from 1989-2004 was carried out. There was no extrusion in any of our cases. Serviceable hearing (<20 dB air bone gap closure) was achieved in 24 out of 37 (65%) over long-term follow up of more than 1 year (mean and median for follow up being 37.4 and 30 months respectively). Thus malleus ossicle graft give acceptable long-term hearing results in one of the most difficult ossiculoplasty situations (absence of stapes suprastructure and malleus) with virtually no extrusion problems.

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Ossiculoplasty using hydroxyapatite prostheses: long-term results

Abstract: The surgical results of ossicular chain reconstruction using a hydroxyapatite prosthesis were evaluated in 106 ears of 101 patients who were followed up for > 5 years. Successful reconstruction was defined as: (1) postoperative air-bone gap of Show more

Cited by 52 publications

References 8 publications

Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results

Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results

The Efficiency of Titanium Middle Ear Prosthesis in Ossicular Chain Reconstruction: Our Experience

Use of autogenic and allogenic malleus in tympanic membrane to footplate assembly — long-term results

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