Novel Ossicular Chain Reconstruction Techniques (2023 AMW) Session
2023 AAO-HNSF Annual Meeting & OTO Experience
PROGRAM DESCRIPTION: 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 issues such as: angulation, dislocation, migration, 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 grafts, partial and total ossicular prostheses, the use of glass ionomer cement, and endoskeletal OCR with the Kraus K-Helix prostheses.OUTCOME OBJECTIVE 1: Demonstrate existing techniques to reconstruct the ossicular chain and discuss the pitfalls of conventional OCR.OUTCOME OBJECTIVE 2: Explain newest techniques for ossicular reconstruction utilizing bone cements and methodology to maintain the given anatomy, improve air-bone gap closure, and achieve long-term, stable hearing outcomes.OUTCOME OBJECTIVE 3: Learn time tested methods to improve long-term hearing outcomes for patients with ossicular discontinuity.BACKGROUND STATEMENT: This course teaches middle ear mechanics and OCR. Participants will be introduced to novel techniques to help both the general otolaryngologist, as well as the otologist, to become more efficient and effective at OCR so as to achieve more stable, long-term hearing results.