Evaluation of hydroxyapatite ossicular chain prostheses

Hydroxyapatite (HA) middle ear prostheses have gained popularity as an alte rnative to human autografts and homografts, This study reports on 3 HA pros theses types: total ossicular chain prostheses, used for grafting the stape s footplate to the tympanic membrane; partial ossicular chain prostheses, u sed for grafting the stapes superstructure to the tympanic membrane; and Ka rtush incus struts (Smith & Nephew Richards Inc), used for grafting the sta pes superstructure to the undersurface of the malleus, This single-surgeon study of 33 consecutive cases revealed a statistically significant differen ce in mean postoperative air-bone gap and air-bone gap closure between incu s struts (14/26 dB) or partial (22/11 dB) or total (25/10 dB) ossicular cha in prostheses (t test: P < 0.05), Prognostic risk factors graded by the Mid dle Ear Risk Index indicate a tendency for worse postoperative hearing with increasing Middle Ear Risk Index. This study supports the use of HA ossicu lar prostheses and, in particular, the use of the malleus for ossicular cha in construction.