Implant Characteristics

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

Shape Size




Easily modified

Table 19-2 Summary of Different Types of Materials for Middle Ear Implants


Hydroxyapatite Plastipore

HAPEX/Flex H/A Titanium

Advantages Biocompatible

Disadvantages May not be present, may have residual disease

Biocompatible, osteoconductive

Not easily trimmed

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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