Minisculptured ossicle grafts versus implants: long-term results

The present study deals with 832 ossicular chain reconstruction procedures performed in 655 patients from January 1975 to December 1985. Homograft and autograft ossicles, intraoperatively minisculptured according to personal or traditional techniques, were used in 626 ears (75.2%). In the remaining 206 ears Plastipore or Proplast total or partial ossicular replacement prostheses were employed. The functional hearing results are evaluated as a function of length of follow-up, techniques used, and preoperative diagnosis. Short-term hearing gain is satisfactory and very similar for both ossicles and implants. Long-term observation however, shows, a progressive and systematic reduction of the postoperative hearing gain for both treatments. The long-term deterioration of hearing levels in ears receiving implants is more evident and dramatic than that observed in ears with ossicles. The difference is statistically significant. The causes of failure are evaluated based on both clinical data and findings at revision surgery.