Use of Hydroxyapatite Implants in Surgery of theMiddle Ear: Compact Ceramics such as TORP, PORP and Porous Ceramics for Reconstruction ofthe Posterior Wall of the Auditory Meatus and for Filling Trepanation Cavities (Part 1)

Overview

In 1995 - 1996 at the ENT Clinic of the Faculty Hospital in Ostrava a total of 24 one-stageoperations of the middle ear were performed where for reconstruction of the chain of ossiclesprefabricates of hydroxyapatite were used (Ca10 (PO4)6(OH)2) with a porosity of 1.4% type PORP,TORP according to Wehrs and Grote and a grooved interponate to bridge the incudostapedial defectaccording to Applebaum. For reconstruction of the posterior wall of the auditory meatus and forfilling the trepanation cavities the authors used porous hydroxyapatite with a porosity of 20-30% inthe shape of a plate - a cone-shaped sector and prisms.In all instances of reconstruction of the chain of ossicles, posterior wall of the auditory meatus andobliteration of the trepanation defect anatomical incorporation occurred without rejection of theceramic material. Only in one instance in an infected medium the prosthesis and filling of thetrepanation defect were rejected after one month. Perforation of the tympanoplastic graft withoutrejection of the ceramic prosthesis type PORP occurred once when three months after surgerytympanometrically obstruction of the Eustachian tube was revealed. Compact as well as poroushydroxyapatite ceramics are easily processed, they are compatible in direct contact with the eardrum, contrary to other hitherto used alloplastic bioactive materials.

Key words:
chain of ossicles, hydroxyapatite, compact, porous, bioactive, reconstruction.