PubMed · 6218244
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J Magnan, A Giovanni, G A Bremond. 1982. [Ossicular prosthesis].. https://pubmed.ncbi.nlm.nih.gov/6218244/
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It is often reported that the repair of subtotal perforations is less successful than that of smaller perforations, mainly because it is technically more difficult. The author's surgical technique for subtotal perforations is presented and the results compared with that of myringoplasty for smaller perforations. The study shows that subtotal perforations are associated with a higher incidence of abnormal middle ear mucosa (chi 2 = 11.75, d.f. = 2) and damage to the malleus (chi 2 = 5.60, d.f. = 1) than smaller perforations. However, the success rate of subtotal perforation closure (92.5%) is as good as the closure rate for smaller perforations (94.1%). It is concluded that the size of the perforation is not a major factor in determining whether the graft will be successful in myringoplasty.
A variety of different implants are available today for use by the otologic surgeon. All prostheses are well tolerated, and the risks of complication as a result of their implantation are comparable. The most commonly used prostheses are the wire-Teflon piston and the stainless steel bucket handle. Although the otologic surgeon has a wide variety of prostheses to choose from, most have a preference for one particular type. Results of hearing improvement following a successful stapedectomy is more a function of the surgeon's experience than of the type of prosthesis used. As James L. Sheehy, MD, so often says, "if a technique is working well for you, don't change for change's sake" (personal communication, 1994).
Plasti-pore, a high-density polyethylene sponge, was one of the earliest biocompatible materials developed specifically for implantation in the middle ear. It is one of the most nonreactive materials known when tested in simulated biochemical exposure to pseudoextracellular fluid. The two basic prosthetic designs are the total ossicular replacement prosthesis and the partial ossicular replacement prosthesis. Plasti-pore implants have now been used for 20 years and are widely accepted by otologic surgeons. The basic properties of the material, implant design, and surgical techniques involved using these prostheses are reviewed in this article.