Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (1): 1-5.doi: 10.6040/j.issn.1673-3770.0.2021.459

   

Preliminary analysis of the position and related factors of titanium ossicular prostheses during mastoid and tympanic revision surgeries

LI Xiaoyu, ZHAO Danheng, LIU Ya, LIU Yang   

  1. National Clinical Research Center for Otolaryngologic Diseases, Senior Department of Otolaryngology Head and Neck Surgery of Chinese PLA General Hospital, Department of Otomicrosurgery, Sixth Medical Center of The PLA General Hospital, Beijing 100048, China
  • Published:2023-02-06

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Abstract: Objective To evaluate the position, clinical characteristics, and related factors affecting implanted titanium ossicular prostheses during middle ear revision surgeries, in order to provide a clinical experience and guidelines for ossicular chain reconstruction. Methods We recruited cases of revision surgeries performed at least 6 months after implantation of titanium ossicles during mastoid tympanoplasties, between 2013 and 2020. We retrospectively analyzed data regarding the positions of the titanium ossicle, the causes of abnormal ossicle position, and the treatment methods. Results Among the 485 cases of tympanoplasty with titanium ossicle hearing reconstruction, 30 cases were reoperated. The prosthesis position was good in nine cases, tympanic membrane(TM)atelectasis and prosthesis protrusion occurred in two cases, TM perforation and prosthesis ejection in seven cases, detachment or angular inclination of the TM in six cases, and detachment of the stapes in six cases. The indications of reoperation included postoperative infection(eight cases), recurrence(fifteen cases), and pure hearing loss(seven cases). The postoperative infections occurred within a month after surgery, but the median times of onset of recurrence and pure hearing loss were 19 months(5-54 months)and 30 months(4-49 months), respectively, following the initial surgery. The position of the ossicular prosthesis was good in 1/3 and 1/2 of the recurrence and infection cases respectively; however, the positions in isolated hearing loss cases were all abnormal. Conclusion Titanium prosthesis osteoplasty is a safe and effective reconstruction method with a low reoperation rate. Poor Eustachian tube function and TM atelectasis are the main causes of prosthesis abnormalities during reoperation. Failure of the previous prosthesis implantations could be the result of dislocation, lodging, protrusion, shedding, foreign body stimulus, and granulation wrapping during reoperation.

Key words: Tympanoplasty, Ossicular chain reconstruction, Titanium ossicular prosthesis, Prosthesis dislocation, Revision surgery

CLC Number: 

  • R775
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