Titanium-anchored prostheses in otology.

In the late 1970s, Per-Ingvar Branemark and coworkers in Goteberg, Sweden, successfully introduced osseointegrated titanium implants into clinical practice. They had achieved the previously elusive goal of producing stable, secure percutaneous implants anchored in underlying cortical bone. Two applications of these implants to otology were obvious: (1) to provide a coupling for bone-conduction hearing aids and (2) to provide fixation points for anchoring of auricular prostheses. Before describing the current state of these clinical applications and considering future potential uses, the authors review the basis for titanium osseointegration.