Incus Replacement Prosthesis in Otosclerosis Surgery

A PROSTHESIS from the malleus handle to the oval window is necessary at times to obtain satisfactory hearing for the otosclerotic patient. The purpose of this paper is to present the indications for and the technique and results of using an incus replacement prosthesis in the otosclerotic ear (Fig 1). Essentially, it represents a progress report, inasmuch as the early results in both the fenestrated and nonfenestrated ear have been reported previously.1,2 The Prosthesis A prosthesis from the malleus handle (incus replacement prosthesis or IRP) was first used by us in 1961 following the lead of Schuknecht and Kos.1A wire and fat prosthesis was used initially. It became apparent, however, that it was not advisable to use a tissue graft in the oval window because of the problem of sensorineural hearing impairment.3A prefabricated wire loop IRP was designed and has been used since 1963. The