Krueger Wesley W O, Feghali Joseph G, Shelton Clough, Green J Douglas, Beatty Charles W, Wilson David F, Thedinger Bradley S, Barrs David M, McElveen John T
The Otology Group, San Antonio, TX 78240, USA.
Otol Neurotol. 2002 Nov;23(6):836-9. doi: 10.1097/00129492-200211000-00004.
Limitations in biocompatibility and hearing improvement with ossicular chain reconstruction prostheses are addressed with new, lightweight titanium prostheses designed to maximize visualization of the capitulum and footplate regions. The effectiveness of these new prostheses is being tested in a prospective multicenter study.
Prospective case series.
Multicenter (8 sites), primarily tertiary private practice or academic otologic clinics.
A convenience sample of 31 patients undergoing ossiculoplasty, with 16 partial ossicular chain reconstructions using the Bell prosthesis and 15 total reconstructions using the Aerial prosthesis.
Ossiculoplasty using new Kurz titanium prostheses. Cartilage was interposed between the tympanic membrane and the prosthesis.
Air-bone gap for pure tone average and 3,000 and 4,000 Hz, assessed preoperatively and 3 months, 6 months, and 12 months postoperatively; percent of patients obtaining an air-bone gap of </=20 dB; high-frequency average (1,000, 2,000, and 4,000 Hz) to evaluate sensorineural hearing loss; and extrusion rate.
A postoperative air-bone gap of </=20 dB was obtained in 81% of Bell prosthesis patients and 67% of Aerial prosthesis patients at 3 months. The results were stable to improved for later time intervals. High-frequency gaps were similar to the pure tone average gap. To date, there have been no instances of extrusion, and all the surgeons found the prostheses easy to use and thought that the design characteristics facilitated accurate placement.
Initial evaluation of the Kurz titanium prostheses produced low extrusion rates (none to date) with excellent hearing results, including good high-frequency conduction. Good visualization and accurate placement were easy to achieve. Further studies are needed to confirm long-term efficacy.
新型轻质钛制听骨链重建假体旨在最大程度地清晰显示小头和镫骨足板区域，以解决现有听骨链重建假体在生物相容性和听力改善方面的局限性。这些新型假体的有效性正在一项前瞻性多中心研究中进行测试。
前瞻性病例系列。
多中心（8个地点），主要是三级私立诊所或学术性耳科诊所。
31例行鼓室成形术的患者组成的便利样本，其中16例使用Bell假体进行部分听骨链重建，15例使用Aerial假体进行全听骨链重建。
使用新型Kurz钛制假体进行鼓室成形术。在鼓膜和假体之间植入软骨。
术前及术后3个月、6个月和12个月评估的纯音平均气骨导差以及3000Hz和4000Hz气骨导差；气骨导差≤20dB的患者百分比；评估感音神经性听力损失的高频平均值（1000Hz、2000Hz和4000Hz）；以及假体脱出率。
3个月时，81%使用Bell假体的患者和67%使用Aerial假体的患者术后气骨导差≤20dB。在随后的时间间隔内，结果保持稳定或有所改善。高频气骨导差与纯音平均气骨导差相似。迄今为止，尚无假体脱出的情况，所有外科医生都发现该假体易于使用，并认为其设计特点有助于准确放置。
对Kurz钛制假体的初步评估显示假体脱出率低（迄今为止无一例），听力结果优异，包括良好的高频传导。易于实现良好的可视化和准确放置。需要进一步研究以证实其长期疗效。
