Reconstruction of the ossicular chain using a multistrand wire spring prosthesis.

A multistrand wire spring prosthesis is presented for ossicular reconstruction. This device offers a workable solution not only to the ossiculoplasty problems associated with lateralization of the tympanic graft and displacement of the prosthesis, but also to other problems such as fixation to middle ear wall, tissue reaction, resorption, degeneration, biodegradation, or poor sound conduction, which are obviated using a stainless steel wire for the ossicular prosthesis. The spring also protects the inner ear from external trauma. Long-term reconstruction results of 14 cases using first generation coil spring prosthesis are presented. A freely mobile prosthesis head composed of cartilage with perichondrium on a wire-mesh platform distributes pressure evenly to the undersurface of the tympanic membrane and further ensures the prevention of pressure necrosis and extrusion. When the handle of the malleus is present, the head-loop assembly of the spring prosthesis is designed to securely capture the handle. There is no practical loss of sound energy passing through the spring. Over a period of 14 years none of the wire prosthesis was found to have eroded through the stapedial footplate.