Abstract
In reconstruction of the ossicular chain, an autograft material would be an ideal ossicle substitute because of its excellent biocompatibility. When the stapes superstructure remains intact, a remnant of the ossicle (usually the incus) is appropriately trimmed and placed between the stapes capitulum and the tympanic membrane. When such ossicle is not available, a piece of cortical bone or auricular cartilage is applied instead. In contrast, when the stapes superstructure is missing, we use Apaceram ossicle with a sliced auricular cartilage on the surface of its head. According to the criteria proposed by the Otological Society of Japan, successful restoration of hearing was obtained in 70%-92% in tympanoplasty type III and 71% in tympanoplasty type IV in the study of 94 cases operated on during the last 5 years.
