Int. Adv. Otol. 2011; 7:(2) 172-177

A New Golden Wire Prosthesis Technique Between the Malleus and Stapes: Our Preliminary Results
Huseyin Katilmis, Hale Aslan, Sinan Basoglu, Ali Ekber, Sedat Ozturkcan, Mehmet Ali Tayfun, Isil Adadan Guvenc, Riza Dundar, Yilmaz Ozkul, Halil Emre Gogus
Department of Otorhinolaryngology and Head and Neck Surgery, Izmir Atatürk Research and Training Hospital, Ministry of Health, Izmir-TURKEY

Objective: Ossicular chain reconstruction in chronic otitis media is still a matter of investigation. Many types of prostheses have been defined. We present biocompatibility-tested golden wire prosthesis used in the presence of a damaged or missing incus and the functional results of chain reconstruction.

Materials and Methods: This report describes a prospective case review from a tertiary referral center. The study was approved by ethics committee of İzmir Ataturk Training and Research Hospital. Ossiculoplasty between the malleus and stapes was performed on a total of 20 patients, including 14 intact-wall Tympanoplasty and 6 canal-wall-down tympanoplasty (CWDT) procedures. Wire prostheses were inserted between the malleus and stapes and the stapedial tendon. Pure tone average thresholds were calculated at 500, 1000, 2000, and 3000 Hz. Preoperative and postoperative air–bone gaps (ABGs) and air-conduction gains (ACs) were compared. An ABG ≤20 dB and AC ≥20 dB were accepted as successful hearing gains.

Results: The placement of the prosthesis was successful in all patients. The mean follow-up period was 11.9 (3–24) months. The preoperative average ABG was 38.25 �} 11.98 dB, and the postoperative average ABG was 17.25 �} 9.92 dB. The preoperative average AC was 53.90 �} 14.99 dB, and the postoperative average AC was 34.05 �} 18.50 dB. These results were statistically significant (P = 0.001). We reached the goal of an ABG <20 dB in 9 (64.3%) of 14 patients who underwent canalwall-up tympanoplasty (CWUT) but in only 2 (33.3%) of 6 patients who underwent CWDT. This difference was statistically significant (P = 0.033).

Conclusion: Despite the limited number of patients, this study demonstrated the effectiveness of the golden wire prosthesis in reconstructing the ossicular chain in the presence of a damaged or missing incus. Biocompatibility, easy accessibility and application of the golden wire, and low cost are the advantages of this technique.