Ossicular Reconstruction with Titanium Prosthesis

Martín, A; Harner, Stephen G.

doi:10.1097/00005537-200401000-00010

Cited by 105 publications

(98 citation statements)

References 5 publications

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“…One or all of these factors can have implications in the use of ossicular prostheses, extrusions and middle ear sound conduction. Similar hearing outcomes have been observed in other studies on type 3 ossicular reconstruction using titanium prostheses [16,20,21].…”

Section: Comparison With Other Studiessupporting

confidence: 89%

“…As an implant connecting tympanic membrane to the stapes head or footplate, titanium is favored because of its rigidity, light weight and biocompatibility [15]. In addition, titanium TORPs and PORPs require cartilage interposition between the implant headplate and the tympanic membrane/fascia to prevent extrusion [16]. A thin slice of cartilage with or without perichondrium is ordinarily recommended as an interposition graft to cause minimal impedance to hearing [16].…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…In addition, titanium TORPs and PORPs require cartilage interposition between the implant headplate and the tympanic membrane/fascia to prevent extrusion [16]. A thin slice of cartilage with or without perichondrium is ordinarily recommended as an interposition graft to cause minimal impedance to hearing [16]. By providing nourishment to the cartilage, perichondrium maintains its vitality, especially in the long term, and hence maintains its structure and shape, avoiding resorption [17,18].…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

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Cartilage Palisades in Type 3 Tympanoplasty: Functional and Hearing Results

Vashishth

Mathur

Verma

2014

Indian J Otolaryngol Head Neck Surg

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To evaluate the functional and hearing outcomes using full thickness broad cartilage palisades for tympanic membrane reconstruction in type 3 tympanoplasty with titanium prostheses. The retrospective study performed at a tertiary referral institute included 30 patients with posterior mesotympanic retraction pockets or tympanic membrane perforations requiring tympanic membrane and type 3 ossicular reconstruction. Patients with disease extending beyond the aditus requiring canal wall down mastoidectomy were excluded. Disease removal from posterior mesotympanic and epitympanic recesses was confirmed using angled endoscopy and ossicular reconstruction was performed using titanium partial or total ossicular replacement prostheses. Tympanic membrane reconstruction was done, with or without attic reconstruction, using full thickness broad cartilage palisades harvested from the tragus with perichondrium attached laterally. Patients were assessed at 24 and 48 weeks for graft status and any evidence of implant extrusion. Hearing evaluation was done using subjective assessment and pure tone audiometry. In total, 27 out of 30 patients had intact and completely healed grafts at 48 weeks postoperatively (a success rate of 90 %) showing full union and epithelialization of palisades, and with three patients displaying small defects. The mean pure tone air bone gap pre-and postoperatively was 32.4 and 8.8 dB, respectively, with most patients reporting satisfactory postoperative hearing. No evidence of implant extrusion was found in the 48-week period. Tympanic membrane reconstruction using full thickness palisades of tragal cartilage provides good functional and hearing outcomes in type 3 tympanoplasty with titanium prostheses.

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Section: Comparison With Other Studiessupporting

confidence: 89%

Section: Comparison With Other Studiesmentioning

confidence: 99%

Section: Comparison With Other Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Cartilage Palisades in Type 3 Tympanoplasty: Functional and Hearing Results

Vashishth

Mathur

Verma

2014

Indian J Otolaryngol Head Neck Surg

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“…A study by Martin et al [15] also reported that ICW procedure achieved a better hearing outcome with titanium prostheses than with CWD procedure.…”

Section: Discussionmentioning

confidence: 93%

Preliminary Hearing Results of Tympanomastoidectomies Using Titanium Prostheses: Scenario in a Developing Country

Sayal¹,

Taneja²,

Gulati³

2013

IJOHNS

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The study was done to review postoperative hearing gain of patients with different Middle Ear Risk Index (MERI) undergoing Tympanomastoidectomies with titanium prostheses reconstruction. A Retrospective chart review was performed from September 2009 to December 2011. Of the 17 cases, 9 had moderate MERI while 8 had severe MERI. 9 patients underwent Tympanomastoidectomy with Total Ossicular Reconstruction Prostheses (TORP) and 8 with Partial Ossicular Reconstruction Prostheses (PORP). Hearing gain of 25.31 dB was achieved in cases with moderate MERI compared to 29.37 dB in severe MERI. Less than 20 dB average air-bone gap was achieved in 75% of PORP and 77.77% of TORP reconstructions. In developing countries with limited resources, decision regarding ossicular reconstruction should be made taking into account MERI, intra operative findings and type of surgery. Best results are achieved in cases of CWD with TORP and ICW with PORP.

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“…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.…”

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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Ossicular Reconstruction with Titanium Prosthesis

Cited by 105 publications

References 5 publications

Cartilage Palisades in Type 3 Tympanoplasty: Functional and Hearing Results

Cartilage Palisades in Type 3 Tympanoplasty: Functional and Hearing Results

Preliminary Hearing Results of Tympanomastoidectomies Using Titanium Prostheses: Scenario in a Developing Country

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

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