Results of tympanoplasty with titanium prostheses☆, ☆☆

To improve the hearing results associated with tympanoplasty, we performed the operation in 113 cases (124 ears) using ossicular replacement prostheses made of titanium. The results demonstrated that among all the operated ears, 115 of 124 (92.7%) had a hearing gain of more than 10 dB. The average improvement of pure-tone hearing was 24.6 dB, and the average reduction of the air-bone gap was 23.2 dB. No rejection reaction or recurrent cholesteatoma was found. This operative technique, based on animal experiments and applied anatomic study of the suprastapedial structure in human beings, has had a good rate of success and has resulted in remarkable hearing improvement of a relatively large magnitude. The application of a new material—titanium—which has high biocompatibility with human body tissues, is in large measure the reason for this success. The ossicular replacement prosthesis was appropriately designed and manufactured. It fit well, could be tightly joined to the suprastapedial structure, and was difficult to displace. We also adopted the method of enlarging the tympanic isthmus, which led to good aeration of the mastoid and attic, resulting in the best state of mobility of the tympanic membrane. All these factors contributed to the effective hearing gain. (Otolaryngol Head Neck Surg 1999;121:606-9.)