Ka. Frese et F. Hoppe, MORPHOLOGY OF AUTOLOGOUS AND HOMOLOGOUS O SSICULAR IMPLANTS AFTER LONG-TERM IMPLANTATION, Laryngo-, Rhino-, Otologie, 75(6), 1996, pp. 330-334
Although ossicular bone implants have been used to restore the middle
ear sound conduction mechanism for more than 30 years, controversy sti
ll exists regarding their morphology after long-term implantation. Met
hods: Fifty-seven ossicular implants that had been in the middle ear f
or a mean duration of 12 years (ranged from 3-33 years) were removed a
t the time of revision surgery and prepared for histological study by
light microscopy. These revision operations were performed because of
failure to control the disease and/or persistent or recurring hearing
loss. Each ossicle was examined for the presence of living bone, exten
ded bone resorption, and inflammatory cells. The findings were correla
ted to origin, duration of implantation, and the reason for revision s
urgery. Results: More than a half of the specimens with cholesteatoma
and chronic otitis media as reasons for revision surgery showed extend
ed bone resorption and inflammatory cells. Even in clinically uninfect
ed ears, inflammation and bone resorption could be observed. Lymphocyt
ic infiltration as an inflammatory pathologic change predominates in a
utologous implants. Conclusions: On the basis of these histological ob
servations, we conclude that autologous ossicles from cholesteatoma sh
ould not be used in reconstructive middle ear surgery. Furthermore, th
e use of ossicular implants after revision surgery should be avoided.