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At least 73 records · Page 4Linked to original sources

Incus reposition: goblet prosthesis.

A stainless steel goblet shaped prosthesis is used to attach the repositioned incus to the stapes. A two year follow-up was made of the first 116 patients in which the prosthesis was used for ossicular reconstruction. The incidence of extrusion and ankylosis is diminished, and 75% of all cases had closure within 10 db. An additional 20% had closure within 20 db of bone conduction thresholds. Revisions have been less with this technique than with others: 40% of 116 patients had an uncomplicated tympanoplasty; 60% had a tympanoplasty with mastoidectomy. The results are, of course, more favorable in the group without mastoidectomy. Of these, 86% had closure to within 10 db of bone conduction level. These findings suggest that the use of the goblet prosthesis results in improved hearing. These findings conclude that the use of the goblet prosthesis results in better hearing than that obtained with other methods of ossicular chain reconstruction.

Ear Ossicles

Age-related bone resorption in the normal incus: a case of maladaptive remodelling?

The changes that occur in the normal human incus with age have been investigated. Evidence for age-related changes in this ossicle, especially in the region of the long process, has been accumulating over the last 30-40 years and yet they have neither been confirmed quantitatively nor explained satisfactorily. In this study the results of a morphometric study of the long processes of a series of normal incudes are presented. These demonstrate that the lenticular and long processes undergo progressive symmetric resorption with advancing age. We consider these findings in the light of previous considerations of incudal remodelling and propose that these remodelling changes may reflect a normal adaptive response to the biomechanical milieu of the human middle ear.

Aged

Congenital absence of incus--a rare abnormality.

A case is described of a nine-year-old girl with a bilateral and symmetrical congenital absence of incus. This very rare abnormality has been described only once previously in the literature. Although the pathology may be rare, treatment is straightforward and prognosis good. A discussion of middle ear embryology and a review of the literature is presented.

Child

The "Y" sign of lateral dislocation of the incus.

This report presents a new sign of ossicular dislocation utilizing high resolution computed tomography of the temporal bone. In the case of lateral dislocation of the incus, a "Y" shaped configuration (Y sign) of the malleoincudal complex is seen in the coronal views even though the axial views present a normal "ice cream cone" configurations.

Adolescent

[Some anatomical features of the long process of the incus].

Investigation of a series of histological sections of 40 auditory bones showed the existence of a dense partially developed connective tissue between the long process of the incus and the lenticular process. This indicates that the lenticular process is a separate bone--the least in the body (weight--0.12-0.20 mg, diameter--0.5-0.8 mm).

Humans

The vascular supply of the lenticular and long processes of the incus.

Previous reports of the blood supply to the lenticular and long processes of the incus have failed to consider the potential contribution of the periosteal vascular plexus. This scanning electron microscopic study of vascular foramina on the cortical bone surface demonstrates that there is no statistical difference between the numbers of vascular foramina on the lenticular and long processes, as opposed to the body and short process. These results suggest that the blood supply to this portion of the ossicular chain may not be as tenuous as has been thought.

Adolescent

[The implantation of lyophilized and gamma-sterilized allogenetic incus and of lyophilized and gamma-sterilized xenogenetic malleus (calf) in rabbits and humans (author's transl)].

The histological reactions to the implantation of allogenetic and xenogenetic lyophilized and gamma-sterilized material into the middle ear of rabbits and men is described. In contrary to the behaviour of allogenetic material the xenogenetic shows a clear minor tendency of revitalisation. The reason is the antigen-antibody-reaction which takes place at the capillary network of the donor and leads to a hylinosis with following obliteration of the vascular rete. Therefore the angiogenetic osteogenesis cannot develop. The clinical usuability of such material is discussed.

Animals

[Investigations on protein metabolism in malleus and incus (author's transl)].

Protein and mucopolysaccharide metabolism was studied in the auditory ossicles of rabbits after administration of tritiated amino acids to three and of S35 to two animals. No differences between S35 and aminoacid turnover was seen, indicating a parallelmetabolism of proteins and mucopolysaccharides of the intercellular substance. The tissue, cartilage and bone, shows a metabolism on the molecular level. Areas of cartilage ground substance adjacent to the incudomalleolar joint and the interglobular spaces are not labelled by the radioactive substances. They are excluded from metabolical turnover, while the adjacent cells remain vital. This observation indicates a change of cellular properties, from cartilage to bone cell. The subperiostal bone has lower metabolism than the underlying skeinlike bone. Few osteones were found.

Animals

Remodelling of the normal incus.

Thirty normal incudes were examined using scanning electron microscopy (SEM) to assess the pattern and degree of bony remodelling. The body and short process appeared stable throughout life. By contrast, the lenticular and long processes demonstrated marked osteoclastic activity with a tendency to undergo progressive erosion with advancing age.

Adolescent