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June 1991

Hydroxyapatite Ossicular Prostheses: Results in 150 Consecutive Cases

Author Affiliations

San Diego, Calif

Arch Otolaryngol Head Neck Surg. 1991;117(6):589. doi:10.1001/archotol.1991.01870180019001

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During the Western Section meeting of the Triologic Society in Santa Barbara, Calif, on January 20, 1991, Robert A. Goldenberg, MD, Dayton, Ohio, reported the use of four designs of hydroxyapatite ossicular prostheses placed in 150 ears. The prostheses were formed entirely of hydroxyapatite and designed as (1) incus prosthesis, (2) incus-stapes prosthesis, (3) partial ossicular replacement prosthesis, and (4) total ossicular replacement prosthesis. Follow-up ranged from 1 to 4 years. The surgery was performed for cholesteatoma (61%), tympanic membrane perforation only (29% ), and assorted other diagnoses (10% ). One third of the ears underwent tympanoplasty, and two thirds underwent mastoidectomy.

Only four of the hydroxylapatite prostheses extruded (2.6%). Dr Goldenberg reported that each instance of extrusion was in ears with extremely aggressive cholesteatoma. He offered the opinion that severely diseased ears have a much greater likelihood of rejecting any prosthesis. Dr Goldenberg reported hearing results comparable with those of other

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