Ossiculoplasty-Surgical Procedures and Reconstruction Materials

In reconstruction of the ossicular chain, an autograft material would be an ideal ossicle substitute because of its excellent biocompatibility. When the stapes superstructure remains intact, a remnant of the ossicle (usually the incus) is appropriately trimmed and placed between the stapes capitulum and the tympanic membrane. When such ossicle is not available, a piece of cortical bone or auricular cartilage is applied instead. In contrast, when the stapes superstructure is missing, we use Apaceram ossicle with a sliced auricular cartilage on the surface of its head. According to the criteria proposed by the Otological Society of Japan, successful restoration of hearing was obtained in 70%-92% in tympanoplasty type III and 71% in tympanoplasty type IV in the study of 94 cases operated on during the last 5 years.