Long-term Results with Hydroxylapatite Middle Ear Implants

Abstract

PURPOSE: This study evaluated long-term results in patients who had ossicular reconstruction with a Goldenberg hydroxylapatite implant.

METHODS: A total of 233 patients underwent implantation; of these, 77 had 5-year or longer follow-up and are the subjects of this study of long-term hearing results. All 233 patients were included for analysis of extrusion rate and postoperative otorrhea.

RESULTS: The hearing success rate at long-term follow-up was 56.8%; the mean air-bone gap was 21.1 dB. Prosthesis extrusion occurred in 5.29% of the 233 patients, and visible slippage occurred in 7.7%. Overall, 50.6% of patients met the criteria for successful hearing, which included no extrusion and a dry ear. Better hearing before surgery and presence of the malleus long process were factors associated with a successful hearing result, as was tympanoplasty alone and canal wall up tympa-nomastoidectomy.

CONCLUSION: Hydroxylapatite hybrid prostheses provide stable hearing results over time with low extrusion and a dry ear overall.

Get full access to this article

View all access options for this article.

References

Grote

. Reconstruction of the ossicular chain with hydroxylapatite prostheses. Am J Otol 1987;8:396–401.

Wehrs

. Incus replacement prostheses of hydroxylapatite in middle ear reconstruction. Am J Otol 1989;10:181–2.

Black

. A universal ossicular replacement prostheses: Clinical trial of 152 cases. Otolaryngol Head Neck Surg 1991;104:210–8.

Goldenberg

. Hydroxylapatite ossicular replacement prostheses: Preliminary results. Laryngoscope 1990;100:693–700.

Goldenberg

. Hydroxylapatite middle ear implants. ENT News 1995;4:15–6.

Van Blitterswijk

Grote

. Biocompatibility of clinically applied ceramic. Ann Otol Rhinol Laryngol 1990;99:3–11.

Goldenberg

. Hydroxylapatite ossicular replacement prostheses: A four-year experience. Otolaryngol Head Neck Surg 1992;106:261–9.

Austin

. Ossicular reconstruction. Otolaryngol Clin North Am 1972;5:145–60.

Goldenberg

. Ossiculoplasty with composite prostheses. Otolaryngol Clin North Am 1994;27:727–45.

10.

Grote

. Reconstruction of the middle ear with hydroxylapatite implants: Long-term results. Ann Otol Rhinol Laryngol Suppl 1990;144:12–6.

11.

Farrior

Nichols

. Long-term results using ossicular grafts. Am J Otol 1996;17:386–92.

12.

Toner

Smyth

Kerr

. Realities in ossiculoplasty. J Laryngol Otol 1991;105:529–33.

13.

Black

. Ossiculoplasty prognosis: The spite method of assessment. Am J Otol 1992;13:544–51.