Bioactive glass ceramic in ossicular reconstruction: a preliminary report.

Current techniques for ossicular reconstruction include ossicular autografts and homografts, and plastic and ceramic prostheses. Experimental testing of ceramic materials has led to the development of a nonporous, bioactive form of glass ceramic (Ceravital) for tympanoplastic reconstruction. To determine the clinical usefulness of these implants, Ceravital ossicular reconstructions were evaluated in 37 patients treated at the University of Michigan Medical Center during an 18-month period. Thirty-two patients (86%) with chronic ear disease underwent Ceravital ossicular reconstruction with tympanoplasty with or without mastoidectomy. Five other patients (14%) underwent ossicular reconstruction--2 for congenital anomalies, 2 for temporal bone trauma, and 1 patient for glomus tympanicum removal. Patient follow-up ranged from 2.2 to 3.8 years, with a mean follow-up period of 2.9 years. Prosthesis extrusion occurred in one case (3%). Mean preoperative and postoperative (2-year) pure tone air-bone gaps were 41.6 dB and 21.3 dB, respectively. Hearing was improved in 35 of 37 patients (95%). Postoperative pure tone air-bone gap was closed to 20 dB or less in 23 patients (62%). Hearing gains were greater with partial rather than total reconstructions (p = 0.14) and significantly greater with intact canal wall rather than canal wall down tympanoplasties (p less than 0.05). Initial results obtained with the Ceravital ossicular prosthesis compare favorably with those obtained using other methods of alloplastic reconstruction. These preliminary data suggest that Ceravital is an effective alternative prosthetic material for ossicular reconstruction.