[Reconstruction of the middle ear with passive implants]

Abstract

Today the middle ear can be reconstructed in various ways: without any ossicular chain reconstruction, with reconstruction using autologous ossicles, with reconstruction using passive alloplastic implants or by using active implants. In recent decades, reconstruction with passive middle ear implants has increased for several reasons. It has been demonstrated that in the case of inflamed mucosa the resorption rate of autologous ossicles is around 15%. Modern alloplastic implants can be considered more resistant to inflammatory processes with high biocompatibility. Furthermore, modern alloplastic implants are low-weight with high rigidity. The greatest advantage lies in better coupling possibilities to the residual ossicular chain because of the introduction of coupling elements and also functional elements which are integrated into the prostheses. Due to the wide variety of passive implants this paper is intended to provide an overview of the best reconstruction solutions for the most typical ossicular chain defects using passive middle ear implants. Particular attention is paid to the use of alloplastic prosthesis compared to the use of autologous ossicles.