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Arch Otolaryngol Head Neck Surg. 2008 Dec;134(12):1283-7. doi: 10.1001/archotol.134.12.1283.

Titanium vs hydroxyapatite ossiculoplasty in canal wall down mastoidectomy.

Author information

1
Department of Otorhinolaryngology, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy. redaelli@med.unibs.it

Abstract

OBJECTIVE:

To report hearing results using a titanium ossicular replacement prosthesis during canal wall down mastoidectomy with tympanoplasty to treat cholesteatoma.

DESIGN:

Retrospective medical record review.

SETTING:

Referral university hospital.

PATIENTS:

Patients with cholesteatoma treated with primary or revision canal wall down mastoidectomy with tympanoplasty in a single stage. Patients with implanted hydroxyapatite prostheses composed a matched control group.

MAIN OUTCOME MEASURES:

Medical records were reviewed for type of ossicular condition, type of prosthesis, and hearing threshold at 1-year follow-up.

RESULTS:

Results are reported as the 5-frequency average air conduction gain, bone conduction gain, and air-bone gap. The malleus handle was present in 24 patients, and the stapes superstructure in 22 patients. Mean (SD) air conduction gain was 7.6 (14.7) dB (P = .001); it was 8.7 (12.0) dB in the group with titanium prostheses and 6.3 (17.4) dB in the group with hydroxyapatite prostheses (P = .54). Bone conduction gain was 1.1 (4.9) dB (P = .19). No patients experienced postoperative impairment of bone threshold greater than 5 dB. Postoperative air-bone gap was 26.5 (15.3) dB; it was 23.8 (15.7) dB in the titanium group and 29.8 (14.6) dB in the hydroxyapatite group (P = .18). Air-bone gap closure was 40%; it was 46.2% in the titanium group and 33.3% in the hydroxyapatite group (P = .35).

CONCLUSION:

Titanium is a satisfactory material for use in ossicular reconstruction and is comparable to hydroxyapatite, although at present, no definitive conclusion about the superiority of titanium can be drawn.

PMID:
19075123
DOI:
10.1001/archotol.134.12.1283
[Indexed for MEDLINE]

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