The ossicle‐cup prosthesis: Five years later

Abstract

The ossicle-cup prosthesis is a semibiologic prosthesis that incorporates a synthetic portion into the remaining (or transplant) ossicle. This assembly is positioned on the stapes capitulum, with the synthetic cup forming a dynamic joint. During 1978, 114 patients underwent surgical procedures in which an ossicle cup prosthesis was used. After 1 year 84% of these patients were within 20 dB of their preoperative bone hearing levels. Patients with a concurrent mastoidectomy did worse than those who underwent only a tympanoossiculoplasty. Five years later, 74% of the successful cases were still within 20 dB of the preoperative hearing levels. Eighteen patients underwent a revision surgical procedure to regain hearing. The postoperative hearing results at 1 year were 50% within 20 dB. The causes of failure included further ossicle necrosis (28%), a laterally healed tympanic membrane (39%), and fixation of the prosthesis (33%). Extrusion of the prosthesis during the 5-year period was between 1% and 2%. Overall, the ossicle cup prosthesis has proved to be a stable assembly, easy to revise, and longlasting. Once successful, three of four cases will retain successful hearing for more than 5 years.

Partial ossicular reconstruction in children: A review of 62 operations

“…We found no dominant causes but noted nearly equal occurrences of further ossicular necrosis and prosthesis dislocation, followed by residual cholesteatoma and obliterative mucosal adhesions. The percentages and causes of failure are similar to those published in other series 1,19–22 . Only two perforations were found at revision to be a cause of failure, both associated with prosthesis extrusion.…”

“…Compared with other series and with our own previous series utilizing the same surgeons, prostheses, and techniques, the results for children were similar to adults (Table XII). 1–6,13,18–24 …”