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Tripod allograft in reconstruction of incudal lesions

Published online by Cambridge University Press:  29 June 2007

Michal Luntz ,
Talia Mark Bentacur  and
Jacob Sadé
Michal Luntz*
Affiliation:
Department of Otorhinolarynology, Sheba Medical Center, Tel Hashomer, Hearing Research Laboratory. School of Medicine and the Biomedical Engineering Program, Tel-Aviv University, Ramat-Aviv, Israel
Talia Mark Bentacur
Affiliation:
Department of Otolaryngology, Sapir Medical Center, Kfar-Saba, Israel
Jacob Sadé
Affiliation:
Hearing Research Laboratory, Chair for Hearing Research, Sackler School of Medicine and the Biomedical Engineering Program, Tel-Aviv University, Ramat Aviv, Israel
*
Michal Luntz, 22 Geller Street, Kfar-Saba 44261, Israel
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Abstract

Long-term results of allograft ossiculoplasty with erosion of the long process of the incus in 44 patients are described. The pyramidal-shaped allograft leans on the stapes, the remaining part of the incus and the side of the malleus - forming a ‘tripod’ shape or construction.

The study includes two groups of patients: group A (34 patients) in whom the pre-operative three-frequency average air-bone gap was 20 dB or more and group B (10 patients), in whom the pre-operative air-bone gap was less than 20 dB. In the latter group the indication for surgery was not their hearing loss, but a different pathological condition (infected retraction pocket, a cholesteatoma, etc.) which necessitated surgical disconnection of the chain during the operation.

The average period of follow-up 46 months for group A and 24.9 months for group B. In group A, the preoperative average air-bone gap was 33 dB. Following surgery, the air-bone gap was 20 dB or less in 27 ears (79 per cent), and 10 dB or less in 18 of them (53 per cent). In group B, pre-operatively, the average air-bone gap was 11 dB. Following surgery, the air-bone gap was either better than before the operation or did not increase by more than 5 dB in eight patients (80 per cent).

Comparison of the audiometric results of 20 patients after mean follow-up times of 23.8 months and 64.9 months shows that no deterioration of hearing occurred in the intervening period. Graft extrusion was not observed in any of the operated ears.

Keywords

TympanoplastyTransplantationhomologous
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 3 , March 1994 , pp. 206 - 211
Copyright
Copyright © JLO (1984) Limited 1994

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References

Armstrong, B. W. (1969) Experiences with the ossicular chain. Annals of Otology, Rhinology and Laryngology 78: 939–950.CrossRefGoogle ScholarPubMed
Austin, D. F. (1971) Ossicular reconstruction. Archives of Otolaryngology 94: 525–535.CrossRefGoogle ScholarPubMed
Austin, D. F. (1976) Transcanal tympanoplasty: a 15-year report. Transactions of the American Academy of Ophthalmology and Otolaryngology 82: 30–38.Google ScholarPubMed
Betow, C. (1982) Twenty years of experience with homografts in ear surgery. Journal of Laryngology and Otology 96 (Suppl. 5): 1–28.Google Scholar
Cody, R. T., Taylor, W. F. (1973) Tympanoplasty: long-term hearing results with incus grafts. Laryngoscope 83: 852–864.CrossRefGoogle ScholarPubMed
Crabtree, J. A. (1982) Tympanoplasty and ossicular reconstruction. The last four years. American Journal of Otology 4: 172–176.Google ScholarPubMed
Davis, A. E. (1988) Homograft material in otolaryngology: the risk of transmitting human immunodeficiency virus. Clinical Otolaryngology 13: 159–161.CrossRefGoogle ScholarPubMed
Emmett, J. R., Shea, J. J., Moretz, W. H. (1986) Long-term experience with biocompatible ossicular inplants. Otolaryngology - Head and Neck Surgery 94: 611–616.CrossRefGoogle Scholar
Farrior, J. B. (1960) Ossicular repositioning and ossicular prosthesis in tympanoplasty. Archives of Otolaryngology 71: 443–449.CrossRefGoogle ScholarPubMed
Goodhill, V., Westerbergh, A. M., Davis, C. (1974) Prefabricated homografts in ossiculoplasty. Transactions of the American Academy of Ophthalmology and Otolaryngology 78: 411–422.Google Scholar
Grote, J. J. (1990) Reconstruction of the middle ear with hydroxylapatite implants: long-term results. Annals of Otology, Rhinology and Laryngology 99 (Suppl. 144): 12–16.Google Scholar
Guilford, F. (1965) Repositioning of the incus. Laryngoscope 75: 236–242.CrossRefGoogle ScholarPubMed
Hall, A., Rytzner, C. (1961) Autotransplantation of ossicles.Archives of Otolaryngology 74: 22–26.CrossRefGoogle ScholarPubMed
Harris, I., Goodhill, V. (1967) Functional viability of tragal cartilage autografts in tympanic surgery. Laryngoscope 77: 1191–1203.CrossRefGoogle ScholarPubMed
Harrison, W. H. (1960) Prosthesis in tympanoplasty. Archives of Otolaryngology 7: 91–96.Google Scholar
Hough, J. V. D. (1982) Experience in tympanoplasty - avoiding revision and complications. Otolaryngology Clinics of North America 15: 845–860.CrossRefGoogle ScholarPubMed
House, W. F., Patterson, M. F., Linthicum, F. H. (1966) Incus homografts in chronic ear surgery. Archives of Otolaryngology 84: 148–153.CrossRefGoogle ScholarPubMed
House, W. F., Sheehy, J. L. (1963) Functional restoration in tympanoplasty. Archives of Otolaryngology 78: 304–309.CrossRefGoogle ScholarPubMed
Jackson, C. G., Glasscock, M. E., Nissen, A. J., Schwaber, M. K., Christiansen, S. G., Smith, P. G. (1983) Ossicular chain reconstruction: the TORP and PORP in chronic ear disease. Laryngoscope 93: 981–988.CrossRefGoogle ScholarPubMed
Jansen, C. (1971) Surgical treatment of the chronically infected ear. Journal of Otolaryngological Society of Australia 3: 153–169.Google ScholarPubMed
Iansen, C. (1973) Heterologous tympanoplasty. Transactions of the American Academy of Ophthalmology and Otolaryngology 77: 111–116.Google Scholar
Lee, K., Schuknecht, H. F. (1970) Results of tympanoplasty and mastoidectomy at the Massachusetts Eye and Ear Infirmary. Laryngoscope 81: 529–543.CrossRefGoogle Scholar
Mair, I. W. S., Pederson, S., Laukli, E. (1989) Audiometric results of TORP and PORP middle ear reconstruction. Annals of Otology, Rhinology and Laryngology 98: 429–433.CrossRefGoogle ScholarPubMed
Marquet, J., Schepens, P., Kuijpers, W. (1973) Experience with tympanic transplants. Archives of Otolaiyngology 97: 58–66.CrossRefGoogle ScholarPubMed
Martin, L. S., Loskoski, S. L., McDougal, J. S. (1987) Inactivation of human T-lymphotropic virus type III lymphadenopathy – associated virus by formaldehyde-based reagents. Applied and Environmental Microbiology 53: 708–709.CrossRefGoogle ScholarPubMed
Palva, T., Palva, A., Karja, J. (1971) Results with two- or three-legged wire columellization in chronic ear surgery. Annal of Otology, Rhinology and Laryngology 80: 760–765.CrossRefGoogle Scholar
Palva, T. (1981) An alternative way of using TORP and PORP. Laryngoscope 91: 1960–1962.CrossRefGoogle ScholarPubMed
Pennington, C. L. (1973) Incus interposition techniques. Annals of Otology, Rhinology and Laryngology 82: 518–521.CrossRefGoogle ScholarPubMed
Plester, D. (1961) Problems in tympanoplasty. Journal of Laryngology and Otology 75: 879–884.CrossRefGoogle ScholarPubMed
Plester, D., Janke, K. (1981) Ceramic implants in otologic surgery. American Journal of Otology 3: 104–108.Google ScholarPubMed
Pulec, J. L., Sheehy, J. L. (1973) Tympanoplasty, ossicular chain reconstruction. Laryngoscope 83: 448–465.CrossRefGoogle ScholarPubMed
Reck, R., Helms, J. (1985) The bioactive glass ceramic ceravital in ear surgery. American Journal of Otology 6: 280–283.Google ScholarPubMed
Sadé, J., Berco, E., Buyanover, D., Brown, M. (1981) Ossicular damage in chronic middle ear inflammationCrossRefGoogle Scholar
Saclé, J., Kremer, S., Luntz, M. (1989) ‘Tripod’ ossiculoplasty in incudal lesions. Archives of Otolaryngology, Head and Neck Surgery 115: 596–599.Google Scholar
Shea, J. J., Homsy, C. A. (1974) The use of proplast in otologic surgery. Laryngoscope 84: 1835–1845.CrossRefGoogle ScholarPubMed
Sheehy, J. L. (1973) Plastic sheeting in tympanoplasty. Laryngoscope 83: 1140–1159.CrossRefGoogle ScholarPubMed
Sheehy, J. L. (1984) TORPS and PORPS. Causes of failure – a report on 446 operations. Otolaryngology – Head and Neck Surgery 92: 583–587.CrossRefGoogle ScholarPubMed
Smyth, G. L. (1982) Five-year report on partial ossicular replacement, prosthesis and total ossicular replacement prosthesis. Otolaryngology – Head and Neck Surgery 90: 343–346.Google Scholar
Wehrs, R. E. (1982) Homograft ossicles in tympanoplasty. Laryngoscope 92: 540–546.CrossRefGoogle ScholarPubMed
Wullstein, H. (1956) The restoration of the function of the middle ear in chronic otitis media. Annals of Otology, Rhinology and Laryngology 65: 1020–1042.CrossRefGoogle ScholarPubMed