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Abstract
Contemporary surgical techniques for treating various pathologies affecting the middle ear address not only eradication of the underlying disease process but also restoration of normal auditory function. Trauma, neoplasms, inflammatory processes and cholesteatomas can erode and alter normal middle ear components and relationships vital for the transmission of auditory energy to the inner ear. Over the last five decades, various ossiculoplasty techniques and prostheses have been studied and reported in the literature. Unfortunately, the multitude of reconstructive techniques attests to the fact that none of the currently available methods are ideal. Numerous combination of the graft position, ossicular interposion, cartilage and bone struts and various types of solid plastics and metal have been used.
Each technique is plagued with its own particular problems, including graft failure, implant extrusions, and persistent & recurrent conductive hearing loss.
There are two schools of thought among otologists with regard to reconstruction of the sound-conducting mechanism of the middle ear:
One group believe that the middle ear should not be violated by nonliving material and that only human autograft or homograft material-usually bone or cartilage-should be used in reconstructing the sound conducting mechanism of the middle ear.
The other group seeks to use the new biocompatible implant materials, developed in recent years by material scientists, to reconstruct the sound conducting mechanism of the middle ear (Emmett, 1995).