Short-term results using Kurz titanium ossicular implants

Abstract

The efficiency of titanium middle ear prosthesis for ossicular reconstruction in chronic ear disease is investigated in a Scandinavian two-center retrospective study from a Norwegian tertiary otology referral center and a Finnish otology referral center. Retrospective chart reviews were performed for procedures involving 73 titanium prostheses between 1999 and 2004. All patients that underwent surgery including the Kurz Vario titanium prosthesis were included in the study, 38 procedures including the partial ossicular replacement prosthesis (PORP) and 35 procedures including the total ossicular replacement prosthesis (TORP). Mean follow-up was 14 months. The ossiculoplasty was performed alone (29 patients) or in combination with other chronic ear surgery procedures (34 patients). Comparisons of preoperative and postoperative pure tone averages (0.5, 1, 2, and 3 kHz) according to AAO-HNS guidelines are presented, as well as data for different PTA definitions. Otosurgery procedures, complications, revisions, and extrusion rates are reported. A postoperative air-bone gap (ABG) of <or=20 dB was obtained in 77% of the patients, 89% for the Bell (Porp) prosthesis, and 63% for the Arial (Torp) prosthesis. Overall mean pure tone averages improved 20.6 dB with ABG improvement of 19.3 dB. The overall extrusion rate was 5% (4 patients). Titanium prostheses have been easy and fast to handle and effective implants for reconstruction of the ossicular chain. We found no difference between reconstruction with or without cholesteatoma surgery during the same procedure. The combination of CWD and Torp gave significant inferior hearing thresholds as compared to Torp/CWU and Porp/CWD combinations.

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

“…Although a few previous studies [14] did find a difference in the hearing outcome between using a PORP and a TORP, we did not find a significant difference in our series. As a larger database of these patients develops, we may be able to determine whether the difference in the hearing outcome between using a PORP and a TORP is significant or not.…”

“…Its use in reconstruction of the ossicular chain during middle ear surgery has been increasing [7,8]. The use of titanium ossicular prosthesis was first reported by Stupp et al in 1999 [9], and later reports have shown success rates (ABG less than or equal to 20 dB) ranging between 57 and 77% [10][11][12][13][14]. We would like to report our results using titanium middle ear prosthesis.…”

Are postoperative hearing results better with titanium ossicular reconstruction prostheses?

“…Not surprisingly, the use of a total ossicular reconstruction prosthesis (TORP) in a canal wall down (CWD) procedure produced significantly worse hearing thresholds compared to a PORP with CWD. 2 Truy et al compared outcomes with HA versus titanium prosthesis reconstruction in 168 patients undergoing ossiculoplasty, and showed that success in terms of ABG of 20 dB or less was achieved in 55% HA TORP, 51% titanium TORP, 72% of titanium PORP, and 67% HA PORP at 2 months. These differences were not statistically significant.…”

A Comparative Clinical Study of Different Prostheses Used in Ossiculoplasty

“…It is an effective and easy material in handling which led to the development of new and versatile designs. 11,17,18 Badr Eldin Mostafa quoted as hearing results reaching as high as 81% in their study. 16 Similar results were reported with titanium implants.…”