[Stapes substitution by cartilage].
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The fate of dentine grafts of autogenous, allogeneic and xenogeneic origin has been studied in rats both in muscle and in the middle ear. The dentine has been implanted fresh, autoclaved, Cialit-preserved and demineralised. Xenogeneic material tends to extrude from the ear and not to form a functional union with the structures it contacts. Fresh or Cialit-preserved, autogenous or allogeneic material, eventually stimulate new bone formation and usually become incorporated into the host ossicular chain; however, continuing resorptive activity is present. Autoclaved material does not result in new bone formation; demineralised allogeneic material stimulates very active new bone formation in the ossicular chain. It is concluded that non-demineralised dentine, on account of resorption, is inferior to ossicular grafts as a tympanoplastic material. Demineralised dentine, by virtue of its bone-inductive potential, may be of value in tympanoplasty.
A cohort of originally 327 healthy children born in 1975 was followed by repeated otomicroscopies and tympanometries from age 5 to age 16 years, in total 9 otomicroscopies. Prevalence of drum pathology, especially myringo-incudo-pexy was investigated. Prevalence of myringo-incudo-pexy was 0.5% at age 5 years, 2.5% at age 7 and 4.2% at age 16. Forty percent of pexies were stable; 36% fluctuated and 26% disappeared. Hearing was surprisingly good at age 16, but the pexy represents a risk for progression.
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In order to elucidate the pathophysiology of an undetermined conductive deafness without perforation of the tympanic membrane, comparative study was made in several factor with conductive deafness which has normal tympanic membrane and may be due to inflammation. Differences and similarities in the manner of ossicular damage were discussed in these conductive deafness. The morbidity rate of conductive deafness without perforation of the tympanic membrane which was undetermined cause, was found in wide age group 7 to 56 years of age. The site of damage was found at portion of the incudostapedial joint. The origin of etiology was estimated may take part in inflammatory process. We emphasized that such as undetermined conductive deafness may increase according to increase of otitis media with effusion.
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