Titanium angular clip: A new prosthesis for reconstruction of the long process of the incus

Abstract

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. © 2009, Otology & Neurotology, Inc.