[Scanning electron microscopy findings in titanium middle ear prostheses].

BACKGROUND

Titanium as a biomaterial in ossicular replacement has widely spread within the last couple of years.

METHODS

23 prostheses (12 PORPs, partial ossicular replacement prostheses and 11 TORPs total ossicular replacement prostheses) removed during revision surgery were studied using scanning electron microscopy. The average implantation time was 8 (range 3-15) months. The specimens were investigated regarding tissue growth, epithelialization, inflammation and cellular signs of rejection.

RESULTS

Only few prostheses were totally covered by connective tissue or epithelium due to technical problems in removing the implant and the covering tissue as one specimen. But this offered the possibility to study the interface at the edges where the tissue was torn off. The connective tissue looked unremarkable. Polygonal squamous epithelium was detected on several implants. Respiratory epithelium with ciliated cells and mucus producing goblet cells was seen in two specimens. In cases of cholesteatoma or protrusion the explanted prostheses showed typical rosette-like formation of hornifying squamous epithelium. According to underlying disease a lymphocytic infiltration could be seen. There were no cellular signs of incompatibility noticed neither macrophages nor foreign body giant cells.

CONCLUSIONS

From these investigations titanium seems to be a favorable biomaterial for ossicular replacement with good acceptance also in an implantation site showing chronic inflammation.