Non-ossicle homograft bone prostheses in the middle ear

Abstract

This thesis proposes the use of human cadaver non-ossicle temporal homograft bone as middle ear reconstructive material. Bone obtained from the otic capsule histologically resembles that of the ossicles more so than any other bone in the body. The otic capsule, due to its proximity to the middle ear, can be harvested with the middle ear structures when bone cores are obtained, making it easily accessible. These prostheses are cost effective because multiple prostheses can be sculptured from one temporal bone core. This paper further proposes the use and introduction of non-ossicle homografts in primary stapedectomy, as well as in selected cases to bypass the incus and the superstructure of the stapes. Audiological data is provided. Some of the grafts have been in the middle ear for up to 5 years. There have been no extrusions and no complications. The method of harvesting, preservation, and sterilization is presented, as well as a pictorial illustration of the finished product and its relation to the natural ossicles. One histological specimen is presented. On the basis of the audiologic results, as well as the fact that no ossicles have extruded and none have been resorbed, it is proposed that non-ossicle temporal bone homografts have a place in transplantation surgery.