2016 Volume 147 Pages 18-19
Ceramic ossicular replacement prostheses have been used for more than 30 years in Japan. The use of these prostheses was limited to certain institutions. Recently, artificial materials, mainly titanium, have come to be used more commonly in Europe and the USA. In Japan also, these new types of prostheses are frequently used to reconstruct the ossicular chain. These prostheses are effective as long ceramics for type IV tympanoplasty and lateralized tympanic membranes. However, there are issues with the surgical method employed to return the lateralized tympanic membrane to its physiological position. In many patients, the tympanic membrane returns to its previous lateralized location after the surgery, resulting in recurrent lateralization. Due to this phenomenon, no desirable amelioration of hearing is observed in some patients. We have reported improvements in hearing with the use of a long ceramic without changing the location of the tympanic membrane. However, there are still patients with extremely lateralized tympanic membranes for whom even the use of the long ceramics proves ineffective for reconstruction of the ossicular chain.
We observed a patient with an extremely lateralized tympanic membrane, which was in such an advanced state, that a finger could easily touch the tympanic membrane through the external ear. We reported a case in which implantation of both P- and T-type ceramics, which were securely stuck to each other with medical Aron-Alpha, into the area between the lateralized tympanic membrane and the stapes improved hearing.
