BIOMATERIALS IN THE RECONSTRUCTION OF THE HUMAN MIDDLE-EAR

The use of biomaterials for reconstruction of the ossicular chain in m iddle ear involves a different approach from that associated with othe r regions of the organism. The features of the implantation site and t he composition of the prosthesis are responsible for functional failur es that result from deterioration or extrusion of the implant. Since t he fifties, different types of materials, both biological and syntheti c, have been employed in the attempt to achieve the ideal middle ear p rosthesis. We present a reprospective study of 166 patients who underw ent ossicular chain reconstruction involving autografts and homografts of cartilage or auditory ossicle (n = 104) or synthetic prostheses (n = 62). We compare prostheses of different compositions on the basis o f the cases of extrusion and the histological deterioration encountere d with each. In our experience, polymers are associated with frequent extrusion a nd deterioration of the biomaterial, while the results a r e better with biological implants and those made of hydroxyapatite.