The confrontation of experimental and clinical experience in otologic surgery

The fate of transplanted ossicles

“…A more important achievement would be total replacement of the bony substance, which in the homograft is certainly dead, and in the autograft is mostly dead, having been severed from its blood supply. Creeping replacement or creeping substitution has been demonstrated some years ago in animal experiments in many laboratories (Stengl et al, 1966;Winter and Hohmann, 1967;Broek and Kuijpers, 1967;Smyth et al, 1967b). Fig.…”

“…IN reconstructing a sound conduction mechanism in tympanoplastic surgery there is no doubt about the short-term efficacy of the transplanted ossicle, either autologous or homologous, providing certain criteria are fulfilled. The circumstances that we regard as desirable for the use of these grafts have been described in previous communications (Smyth and Kerr, 1967;Smyth et at., 1967a) and the purpose of this paper is to consider, not the indications for their use, but rather their fate in the middle ear. The critics of ossicular transplantation claim that, while the initial results may be encouraging, the long-term results probably will be disappointing.…”

How Can an Underlaid Fascia Graft Form the Middle Layer of a Reconstructed Tympanic Membrane?

“…Many experimental studies have been carried out concerning the tissue embedding of connective tissue and fascia flaps. The experiments of Smyth et al 7 with fascia flaps demonstrated perfect constitution after transplantation. Their results were confirmed by the investigations of Salen 8 on cats.…”