Many materials have been used for ossicular substitution or reconstruction. The ideal prosthesis for ossicular reconstruction should be made of material that maintains its shape, rigidity, and acoustic properties, as well as being cost-effective. This material should also be biocompatible, safe, and easily inserted and modified (Table 19-1).
Table 19 -1 Considerations for the Ideal Prosthesis
Table 19-2 Summary of Different Types of Materials for Middle Ear Implants
HAPEX/Flex H/A Titanium
Disadvantages May not be present, may have residual disease
Not easily trimmed
Not biocompatible, high extrusions
Easily trimmed, biocompatible
Rigid, lightweight Reactivity? Cost
Ossicular reconstruction materials are categorized as autografts, homografts, and alloplastic prosthe-tics. Each of these materials has advantages and disadvantages for use in the middle ear (Table 19-2).
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