Reconstruction of the middle ear with hydroxylapatite implants: long-term results.

The results are reported of reconstructions of the middle ear with hydroxylapatite implants performed between 1980 and 1986 with an average follow-up of 5 years. The findings concern 120 canal wall prostheses made of hydroxylapatite. It was possible to reconstruct a radical cavity with a new ear canal. The results obtained with ossiculoplasty in 170 patients are reported. In patients lacking an incus, an incus prosthesis made of hydroxylapatite gave air-bone gap closure to within 20 dB in 83.3% of the patients. Extrusion was not observed. In cases with the stapes superstructure and incus both missing, an incus/stapes prosthesis made of hydroxylapatite gave an air-bone gap closure to within 20 dB in 75.7% of the cases, when used as an assembly. Extrusion was not observed. When the prosthesis was used as a columella, the results were less favorable (41.1%), and two prostheses were extruded during the postoperative control period. Recurrent cholesteatoma was not seen in cases in which eradication and reconstruction were staged.