Ossicular Replacement With Self-stabilizing Presculptured Homologous Cartilage

The use of self-stabilizing, alloplastic ossicular replacement prostheses introduced by Shea and Homsy has improved postsurgical hearing results in patients with major ossicular defects. While hearing results after total and partial ossicular replacement are good, many authors have reported high rates of extrusion of these alloplastic materials. A technique is herein described in which an all-cartilage homograft is presculptured into a self-stabilizing configuration. Twenty-three such total and partial ossicular replacement grafts were performed with a follow-up of at least 25 months; none of the cartilage struts has extruded. The self-stabilizing, presculptured homologous cartilage graft provides an alternative for surgeons who wish to avoid alloplastic materials in ossicular reconstruction. (Arch Otolaryngol 1982;108:560-562).