PubMed · 5763917
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C Rytzner. 1969. Ossicular transposition.. https://doi.org/10.1001/archotol.1969.00770020228003
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Homograft human bone is not only the most logical choice for grafting material, but also the closest transplantation material to the host histologically. This article discusses surgical repair of the ossicular chain with homograft bone transplants, including rationale for present surgical techniques, a thorough description of simple methods of microlathing homograft bone grafts, and instructions for maintaining an ossicular replacement bone bank. Furthermore, results in all types of ossiculoplasty and a method of classification of tympanoplasty are presented in this article.
OBJECTIVES: The aim of this study is to describe a method to repair small defects (1 to 2 mm) of the ossicular chain by means of glass ionomer cement (GIC) alone. Larger defects can be repaired with a combination of GIC and a platinum wire prosthesis. GIC is a two-component hybrid material consisting of inorganic glass particles surrounded by an insoluble hydrogel matrix. GIC has been used by dentists for many years, but only a few reports describe the use of GIC in human middle ear surgery. Many investigators have proved that most GICs are biocompatible, biostable, and well tolerated by bone and soft tissue. STUDY DESIGN: From 1994 to 1996 GIC was used in 97 middle ear operations. In 44 cases small defects of the ossicular chain were reconstructed with GIC alone. The observation period ranged from 1 to 4 years. METHODS: Nearly all operations were performed with the patient under local analgesia. RESULTS: The postoperative air-bone gap was less than 20 dB in 83.3%. Compared with results from comparable operations, the GIC results are significantly better. One patient had reoperation because the cement had loosened from the bone as a result of faulty GIC operation technique. CONCLUSIONS: Repair of defects of the ossicular chain with GIC is an easy, efficient, quick, and inexpensive method, which ought to be kept in mind for future middle ear surgery. No complications in the middle ear were related to GIC.