Interposed Cartilage as a Precaution against Extrusions of Ceramic Ossicular Replacement Implants

1987 ◽  
Vol 96 (2) ◽  
pp. 207-209 ◽  
Author(s):  
Christoph Zöllner
Keyword(s):  
Middle Ear ◽  
Ossicular Chain ◽  
Oxide Ceramic ◽  
Small Disk ◽  
Middle Ear Implant ◽  
Ossicular Replacement ◽  
Middle Ear Implants ◽  
Aluminum Oxide Ceramic ◽  
Postoperative Observation

Since 1980 we have used middle ear implants of aluminum oxide ceramic in some reconstructions of the ossicular chain. We had opportunities to examine 108 ears (91 patients); the longest period of postoperative observation was 4 years. Follow-up examinations showed that the rates of extrusion and liability to extrusion can be reduced by interposing a small disk of autologous cartilage and perichondrium. Moreover, interposing cartilage tends to improve audiometric results. On the basis of our study, we strongly recommend the interposition of a disk of autologous cartilage and perichondrium between the middle ear implant and eardrum when an Al2O3 implant is used.

Ossicular chain reconstruction: endoscopic or microscopic?

2021 ◽  
pp. 1-7
Author(s):  
E A Guneri ◽  
A Cakir Cetin
Keyword(s):  
Word Recognition ◽  
Middle Ear ◽  
Risk Index ◽  
Ossicular Chain ◽  
Recognition Score ◽  
Reconstruction Surgery ◽  
Ossicular Chain Reconstruction ◽  
Operation Duration ◽  
Air Conduction

Abstract Objective To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery. Methods Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air–bone gap, air–bone gap gain, word recognition score, mean operation duration and mean post-operative follow up. Results Post-operative air conduction, air–bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air–bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air–bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001). Conclusion Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

Hydroxylapatite Ossicular Replacement Prostheses: A Four-Year Experience

1992 ◽  
Vol 106 (3) ◽  
pp. 261-269 ◽  
Author(s):  
Robert A. Goldenberg
Keyword(s):  
Surgical Technique ◽  
Middle Ear ◽  
Control Group ◽  
Hearing Results ◽  
Extrusion Rate ◽  
Hearing Result ◽  
Ossicular Replacement ◽  
Middle Ear Implants

Between 1987 and 1991, I have used 215 hydroxylapatite middle ear implants, in various styles, for hearing reconstruction. The first such implants were composed entirely of hydroxylapatite. Because of intraoperative difficulties in shaping and trimming these prostheses, hybrid prostheses using Plasti-Pore were developed. For each of four implant designs (incus, incus-stapes, PORP, and TORP), the head is constructed from hydroxylapatite and the shaft from Plasti-Pore. Extrusion rate for the hybrid prostheses is low (4.3%). Hearing results from 47 patients with the hybrid hydroxylapatite prostheses, 140 patients with total hydroxylapatite prostheses, and 75 control group patients with homograft bone or Plasti-Pore prostheses were compared. A “successful” hearing result was achieved in 51.1%, 51.4%, and 60.0% of the three groups, respectively. Surgical technique for use of the new hybrid hydroxylapatite prostheses is described.

A new semi-implantable middle ear implant for sensorineural hearing loss: three-years follow-up in a pilot patient’s group

2017 ◽  
Vol 138 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Maurizio Barbara ◽  
Luigi Volpini ◽  
Chiara Filippi ◽  
Francesca Atturo ◽  
Simonetta Monini
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Middle Ear ◽  
Sensorineural Hearing ◽  
Middle Ear Implant

Sound Evaluation of Partially Implantable Piezoelectric Middle Ear Implant: Comparative Study of Frequency Responses

1994 ◽  
Vol 73 (2) ◽  
pp. 108-111 ◽  
Author(s):  
Kazuoki Kodera ◽  
Jun-Ichi Suzuki ◽  
Kyoko Nagai ◽  
Takao Yabe
Keyword(s):  
Frequency Response ◽  
Middle Ear ◽  
Hearing Aid ◽  
Sound Quality ◽  
Speech Discrimination ◽  
Speech Discrimination Tests ◽  
Frequency Responses ◽  
Middle Ear Implant ◽  
Middle Ear Implants ◽  
External Component

Two comparative studies were performed in six subjects using partially implantable middle ear implants (MEI). The sound quality was evaluated by speech discrimination tests and sound evaluation tests. In the first experiment, the performance of the output transducer of the MEI and an ear phone of a conventional hearing aid was compared. The MEI showed better results than the hearing aid in both the speech discrimination tests and sound quality rating. In the second experiment, four kinds of frequency responses for the external component of the MEI were compared. Sound quality evaluation in a wide frequency response with a peak at 4000 Hz were superior to those with the frequency response of the present MEI model. In conclusion, improvement of the external component in the frequency response can provide better performance of the MEI.

Tympanosclerosis of the middle ear: Late results of surgical treatment

1990 ◽  
Vol 104 (9) ◽  
pp. 685-689 ◽  
Author(s):  
Mirko Tos ◽  
Torben Lau ◽  
Helge Arndal ◽  
Søren Plate
Keyword(s):  
Middle Ear ◽  
Ossicular Chain ◽  
Late Results ◽  
Observation Time ◽  
Type Ii ◽  
Stapes Fixation ◽  
One Stage ◽  
Stapes Footplate ◽  
Two Stages

AbstractThe late results of one stage operation for middle ear tymanosclerosis in 73 patients during the period January 1965 to December 1980 are presented. Mean observation time was 11.2 years (range 3–20.2 years), with a follow-up rate 86 per cent. Among 64 patients with stapes fixation, 59 had removal of tympanosclerotic masses and stapes mobilization, and five cases underwent stapedectomy. The series was divided into six groups and the results analyzed. The best and most stable results occurred in the group with stapes mobilization and an intact ossicular chain followed by the group with stapes mobilization and Type II tympanoplasty with incus interposition. The poorest late results were obtained in ears with lacking stapes crura and stapes mobilization, and in ears subjected to stapedectomy. No case of post-operative sensorineural hearing loss occurred. We recommend that care is taken to preserve an intact ossicular chain at stapes mobilization performed at the same stage as myringoplasty. Also in ears with a defective ossicular chain but intact stapes with tympanosclerotic fixation we recommend stapes mobilization in one stage. In ears with fixation of the stapes footplate and defective crura, we recommend stapedectomy or stapedotomy in two stages.

Bioinert Ceramic Implants in Middle Ear Surgery

1981 ◽  
Vol 90 (6) ◽  
pp. 640-642 ◽  
Author(s):  
Klaus Jahnke ◽  
Dietrich Plester
Keyword(s):  
Aluminum Oxide ◽  
Middle Ear ◽  
Animal Experiments ◽  
Surgical Techniques ◽  
Middle Ear Surgery ◽  
Oxide Ceramic ◽  
Ear Surgery ◽  
Ceramic Implants ◽  
Aluminum Oxide Ceramic ◽  
Bioinert Ceramic

The suitability of different ceramic materials for reconstructive middle ear surgery was examined in extensive animal experiments. Since 1978 we have used more than 250 aluminum oxide ceramic implants for ossicular chain reconstruction. The excellent tolerance of this bioinert material was confirmed. The ease and precision with which these implants can be drilled during the operation is especially advantageous. The indications and techniques for the use of the aluminum oxide ceramic implants are described. Our short-term results stimulated the further development of bioinert ceramic implants and our surgical techniques. The special characteristics of bioactive ceramics are such that they can form a tight bond to osseous bone. They are intended for filling bone cavities (porous tricalcium phosphate ceramic) and for reconstruction of the posterior canal wall.

Immunodiffusion and Immuno-histochemical Investigations on the Reactivity of Oxide Ceramic Middle-Ear Implants

ORL ◽  
1993 ◽  
Vol 55 (4) ◽  
pp. 216-221 ◽  
Author(s):  
A. Schadel ◽  
G. Thun ◽  
L. Stork ◽  
R. Metzler
Keyword(s):  
Middle Ear ◽  
Oxide Ceramic ◽  
Middle Ear Implants

Efficacy of the active middle-ear implant in patients with sensorineural hearing loss

2013 ◽  
Vol 127 (S2) ◽  
pp. S8-S16 ◽  
Author(s):  
C L Butler ◽  
P Thavaneswaran ◽  
I H Lee
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
Sensorineural Hearing ◽  
Active Middle Ear Implant ◽  
Middle Ear Implant ◽  
Significant Difference ◽  
Middle Ear Implants ◽  
Better Than

AbstractIntroduction:This systematic review aims to advise on the effectiveness of the active middle-ear implant in patients with sensorineural hearing loss, compared with external hearing aids.Methods:A systematic search of several electronic databases, including PubMed and Embase, was used to identify relevant studies for inclusion.Results:Fourteen comparative studies were included. Nine studies reported on the primary outcome of functional gain: one found that the middle-ear implant was significantly better than external hearing aids (p < 0.001), while another found that external hearing aids were generally significantly better than middle-ear implants (p < 0.05). Six of the seven remaining studies found that middle-ear implants were better than external hearing aids, although generally no clinically significant difference (i.e. ≥10 dB) was seen.Conclusion:Generally, the active middle-ear implant appears to be as effective as the external hearing aid in improving hearing outcomes in patients with sensorineural hearing loss.

scholarly journals Active middle ear implantation: imaging in the pre-operative planning and post-operative assessment of the Vibrant SoundbridgeTM

2020 ◽  
Vol 93 (1109) ◽  
pp. 20190741 ◽  
Author(s):  
Christian Burd ◽  
Irumee Pai ◽  
Steve EJ Connor
Keyword(s):  
Middle Ear ◽  
Ossicular Chain ◽  
Vital Role ◽  
Sound Waves ◽  
Active Middle Ear Implant ◽  
Middle Ear Implant ◽  
Surgical Access ◽  
Implant Placement ◽  
Pictorial Review ◽  
Operative Planning

Active middle ear implants augment sound waves and directly stimulate the middle ear structures. The most frequently utilised active middle ear implant is the Vibrant Soundbridge TM (VSB). CT plays a vital role in appropriate patient selection and surgical planning of active middle ear implant surgery. The VSB TM offers a number of options for implant placement. The ideal location is influenced by the patient’s middle ear and mastoid anatomy as well as the type and severity of the hearing loss. CT provides important information on the surgical access to the middle ear and helps determine the most appropriate implant site by assessing the adjacent middle ear anatomy and the continuity of the ossicular chain. Post-operative active middle ear implant imaging may be indicated in the setting of poor auditory outcomes and when revision surgery is being considered so as to assess for suboptimal implant placement or migration. This pictorial review will describe the VSB TM middle ear device and explain the role of imaging in both the pre-operative and post-operative settings.

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