Novel Ossicular Chain Reconstruction Techniques (2022 AMW)
2022 AAO-HNSF Annual Meeting & OTO Experience
Many techniques have been described for ossicular chain reconstruction (OCR). Despite historic innovations, long-term hearing results with OCR are often less than optimal due to prosthesis related issues such as: angulation, dislocation, erosion, and extrusion. Some issues are related to the inimical habitat of the chronic ear. Others are secondary to an incomplete understanding of fundamental middle ear mechanics and the many technical challenges associated with OCR. The result is wide variability in success rates. This course will review: (1) challenges encountered in chronic ears during OCR, (2) fundamental concepts of middle ear mechanics that are crucial for long-term OCR success, and (3) many OCR techniques that are available including the use of homograft ossicles, cortical bone, cartilage, partial and total ossicular prostheses, and endoskeletal OCR with the Kraus K-Helix prostheses. Additionally, we will demonstrate novel techniques used to perform OCR without the need for PORPs and TORPs. Experienced instructors will review: (1) middle ear conditions that need to be considered during OCR, (2) current knowledge concerning normal ossicular chain mechanics, (3) the absolute importance of achieving optimal prosthesis tension during OCR, (4) methodology to improve air-bone gap closure and limit extrusion, (5) techniques for the use of hydroxyapatite and glass ionomer cements, and (5) a summary of the instructors’ long- term hearing results with OCR. This course has direct relevance to every surgeon who performs otologic surgery and will enhance their surgical armamentarium, especially when faced with anatomic challenges during OCR.
Credits
CME:1.0, MOC:1.0