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"Middle Ear Ossiculoplasty." vol.

Hydroxyapatite is a calcium phosphate ceramic whose elemental constituents closely resemble those of the mineral matrix of human bone3. Hydroxyapatite prostheses are widely used for ossicular reconstruction because of their excellent biocompatibility2 and favorable properties. Even though having favorable properties with HAP ossicular implants, the extrusion rate with HAP prosthesis is >7%3.

Austin DF. Ossicular reconstruction. Otolaryngology Clinics of North America. 1972; 5:689-714

The Bojrab implant line of ossicular reconstructive prostheses has a long history of excellent performance in middle ear surgery and hearing outcomes. As one of the first adjustable titanium prosthesis to offer a titanium shaft combined with a hydroxylapatite (HA) head, the Bojrab style implants have become the popular choice of medical professionals worldwide. The addition of the titanium malleus arm is a favorite among the proponents for saving and using the malleus. The natural progression of creative ideas led to the addition of an integrated footplate shoe for improved stability in malleus to footplate hearing restoration for conductive hearing loss.

Ossiculoplasty and Stapedioplasty with Titanium Prostheses

(A) Plastipore partial ossicular replacement prosthesis (PORP) placed on top of the stapes.

Patients with a history of chronic ear discharge and conductive deafness were included in the study. Out of 21 patients with ossicular chain defect included in the study, 10 patients underwent ossiculoplasty with autograft incus and 11 with titanium prosthesis. Pure tone audiogram was done after three months.

In patients with incus ossiculoplasty, average Post operative PTA was 43.5 dB ± 7.934SD and Net gain in hearing was 10.7 decibels ± 15.478SD. In patients with titanium prosthesis ossiculoplasty, average Post operative PTA was 41.4 dB ± 4.789SD and Net gain in hearing was 16 decibels ± 11.981SD.

of titanium ossicular chain reconstruction, ..

(A) Partial ossicular replacement prosthesis (PORP) and total ossicular replacement prosthesis (TORP) by Kurz.

This focus has led to a deficiency in knowledge about other areas of possible improvement, such as research into how to more accurately mimic the acoustic response of the ossicular chain with the shape of the prosthesis.

In conclusion, we would like to state that the titanium prosthesis (Eon Meditech Pvt. Ltd., India) is biocompatible, delicate and easy to handle. They have proven to be suitable implants for ossicular chain reconstruction and are efficient in transferring sound energy from the tympanic membrane to the oval window. Our early experience with this prosthesis has shown encouraging results.

Fong JC, Michael P, Raut V. Titanium vs autograft ossiculoplasty. Acta Otolaryngol. 2010 ;130(5):554-8
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Ossicular Reconstruction | Clinical Gate

Tympanoplasty (TIM-pan-o-plas-tea) is surgery to rebuild the damaged structures of the middle ear, including the eardrum and . There are limits to what can be achieved. A rebuilt middle ear seldom works as well as the original. Repairing the eardrum is myringoplasty (mi-RING-o-plas-tea). Rebuilding or replacing the ossicles is ossiculoplasty (oss-SICK-you-low-plas-tea). Tympanoplasty is the general term that covers both. Often, we don’t know how much reconstruction will be needed, or possible, until we are part way through the operation. Sometimes, tympanoplasty is done together with mastoidectomy, as part of the same operation. Other times it is done at a later stage, as a second operation, once we are satisfied that the cholesteatoma has been removed and any infection has settled.

Results With Titanium Ossicular Reconstruction ..

Through continued development, it is possible that complete restoration of hearing through the use of ossicular implants might some day become a reality.

With Titanium Ossicular Reconstruction Prostheses

For these people, the impact of engineering on their daily lives has been profound, since many everyday activities such as conversation or listening to the radio are made possible for them through ossicular implants.

Ossicular Chain Reconstruction ..

One of the most important considerations in the structural design of ossicular implants (second only to functionality considerations) has been the need to design them so that they are both easily manufactured and customizable by a surgeon during the implant procedure [5].

Ossiculoplasty: History of the Procedure, Problem, …

In order to objectively assess our results, we have used guidelines (Indian Speech and Hearing Association) to quantify the hearing loss of our patients. We had seven patients who had a central perforation and a mild hearing loss pre-operatively (26–40 dB). However, during surgery, 6 of those patients had a necrosed long process of incus and a normal and mobile stapes, while 1 patient had a necrosis of the long process of incus as well as the stapes suprastructure and only had a mobile stapes footplate. Hence, ossicular chain reconstruction was performed in these patients. Post-operatively, almost 95% (18 out of 19) patients have normal hearing to a mild hearing loss, while one patient has a moderate hearing loss. This patient had undergone a tympanoplasty with TORP placement and has had a hearing gain of 20 dB.

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