The ideal prosthesis must be biocompatible, able to optimize sound conduction based on material and weight, and easily trimmed. The prosthesis must not extrude or move once placed. Failures with reconstruction occur from movement at either the lateral
Table 19-4 Anatomic Variants that May Be Encountered in the Middle Ear and Solutions to the Problem: Stabilization of prosthesis
Stapes capitulum Stapes no capitulum Footplate normal Footplate abnormal Narrow Center ridge Tilted
Slightly rounded head Cartilage cap Middle ear glue
Prosthesis stem hole Alter stem size Small with tissue ingrowth Small with tissue stabilization
FIGURE 19-2 (A,B) The use of the Bojrab universal prosthesis design.
or medial connection. Dense HA has the advantage of being bioactive, allowing epithelial covering, and being osteoconductive. To allow for variations in size intraoperatively, the original composite Bojrab universal prosthesis has a stem that can be trimmed with a head design that is biocompatible against the tympanic membrane (Fig. 19-2). The design of this prosthesis allows use in multiple situations: as an incus-interposition, as a PORP, and as a TORP, depending on the ossicles present (Table 19-5).
Was this article helpful?
Have you recently experienced hearing loss? Most probably you need hearing aids, but don't know much about them. To learn everything you need to know about hearing aids, read the eBook, Hearing Aids Inside Out. The book comprises 113 pages of excellent content utterly free of technical jargon, written in simple language, and in a flowing style that can easily be read and understood by all.