OBJECTIVES To describe a new titanium angular clip prosthesis for bridging the incudostapedial joint in the event of an isolated lesion of the distal end of the long process of the incus. STUDY DESIGN Clinical retrospective study. METHODS We retrospectively reviewed the course of 22 patients with isolated defects of the long process of the incus where the ossicular chain was reconstructed by a titanium angular clip prosthesis. RESULTS The placement of the prosthesis was successful in all patients, and no complication was encountered during its installation. At the first follow-up visit after 3 weeks, the mean air-bone gap (ABG) was reduced by around 10 dB from a mean of 26 dB preoperatively to 16 dB postoperatively. The mean postoperative hearing result of patients with a Type A tympanogram (7-dB ABG) was consistently better than for patients with a Type B or a Type C tympanogram (19-dB ABG in both). CONCLUSION Despite the limited number of patients, this preliminary study demonstrates the effectiveness of the angular clip prosthesis in reconstructing the ossicular chain. In cases of a normal aeration of the tympanic cavity, this reliable reconstruction of the biological chain offers a near-to-normal hearing restoration.
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