MANY TECHNIQUES have been used in an attempt to restore hearing in cases in which the ossicular tissue has been totally destroyed by chronic ear disease. Unfortunately, good hearing results have been very difficult to obtain for these patients.
Wullstein's Type IV Technique.—In the Wullstein type IV procedure the oval window is exteriorized and the round window protected by a skin graft. When successful, this technique still results in a residual 30 db bone air gap. Since these cases seldom have more than a 40 to 45 db bone air gap initially, the degree of hearing improvement is only 10 or 15 db in most instances.1Prosthetic Techniques.—Various prosthetic devices have been used to form a columella between the stapes footplate and the tympanic membrane graft. These techniques include polyethylene tubing with the lateral end flared or covered with wire mesh. Extrusion of these devices occurred
HOUSE WF, PATTERSON ME, LINTHICUM FH. Incus Homografts in Chronic Ear Surgery. Arch Otolaryngol. 1966;84(2):148–153. doi:10.1001/archotol.1966.00760030150007
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