Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (22): 3505-3509.doi: 10.3969/j.issn.2095-4344.3186

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Application of titanium ossicular prosthesis in one-stage open tympanoplasty for middle ear cholesteatoma

Wang Shengjun, Yin Fei, Jiang Maoyu   

  1. Department of Otorhinolaryngology, First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei 230001, Anhui Province, China
  • Received:2020-05-29 Revised:2020-06-02 Accepted:2020-07-23 Online:2021-08-08 Published:2021-01-19
  • Contact: Wang Shengjun, PhD, Associate chief physician, Department of Otorhinolaryngology, First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei 230001, Anhui Province, China
  • About author:Wang Shengjun, PhD, Associate chief physician, Department of Otorhinolaryngology, First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei 230001, Anhui Province, China

Abstract: BACKGROUND: With the development of modern otological microsurgery, for the lesions involving the ossicular chain, surgeons are required to select appropriate surgical methods to reconstruct the ossicular chain on the basis of thorough removal of the lesions. Titanium ossicular prosthesis becomes an appropriate material for reconstruction of the ossicular chain.
OBJECTIVE: To analyze the clinical effect of titanium artificial ossicular prosthesis in one-stage open tympanoplasty for middle ear cholesteatoma.
METHODS: This study enrolled 75 middle ear cholesteatoma patients admitted to the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from August 2015 to November 2018, including 40 males and 35 females, aged 4-76 years old. All patients underwent mastoidectomy and tympanoplasty. In the first stage of the operation, partial titanium artificial ossicles were implanted in 61 cases  and total titanium artificial ossicles were implanted in 14 cases. A thin cartilage perichondrium complex was placed between the tympanic membrane graft and the titanium artificial ossicle. The air, bone conduction threshold, and air bone conduction difference of 75 patients before and 6 months after the operation were compared to evaluate the hearing recovery after the operation. This study was approved by the First Affiliated Hospital of University of Science and Technology of China. 
RESULTS AND CONCLUSION: (1) The follow-up time of all cases was ≥ 6 months. The outcome of dry ear was achieved about 4-6 weeks. At 6 and 12 months after the operation, the otoscope observation showed that the mastoid cavity was well epithelialized, the tympanic cavity was full of air, and the external auditory meatus was spacious and unobstructed. Totally 71 cases of tympanic membrane transplantation healed at the first stage, 3 cases of artificial ossicles were partially prolapsed, and 3 cases of ossicles were completely lost. (2) At 6 months after operation, the air conduction hearing threshold of 75 patients was lower than before operation (P < 0.05). There was no significant difference between bone conduction threshold and preoperative comparison (P > 0.05). (3) The results showed that the one-stage reconstruction of ossicular chain with titanium artificial ossicles on the basis of debridement of lesions in open tympanoplasty can achieve satisfactory hearing effect, with fewer postoperative complications and lower rejection reaction, which is a better optimal treatment option.

Key words: materials, artificial ossicle, cholesteatoma, middle ear, tympanoplasty, ossicular chain reconstruction, ossicular prosthesis

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