RECONSTRUCTION of the middle-ear chain is an important part of tympanoplastic procedures. As the use of alloplastic prostheses in chronic ear surgery does not always lead to the desired improvement in hearing, and the prosthesis is often extruded, many surgeons prefer bone or cartilage if possible.
The fate of cortical bone grafts in middle ear and bulla of experimental animals has been studied extensively,1,2 and from these studies we know these grafts revitalize. Transposition of the incus between malleus and stapes in dogs3 and between malleus and footplate in apes and cats,4 has shown different degrees of remodeling in the incus.
In humans this transposition of the incus has been advocated by Hall and Rytzner,5 Guilford,6 and House,7 who obtained good functional results. Histologic examination in one of the reports5 left doubt about the vitality of the transposed ossicle. Kley and Draf8
Broek PVD, Kuijpers W. Incus Autografts and Homografts in Rats. Arch Otolaryngol. 1967;86(3):287–293. doi:10.1001/archotol.1967.00760050289009