Usage of Homograft Bone in Stapedectomy: KHMC Experience

Mohammed Ali Hiari

Abstract


Objective: The objective of this study is to show the efficacy, safety and feasibility of using homograft bone prostheses in middle ear reconstruction.

Material and Methods: Twenty subjects (12 males, 8 females) with a mean age of 32.6 years (age range15-47 years) presented with unilateral 3 (15%) or bilateral 17 (85%) conductive hearing losses and were diagnosed as having otosclerosis. Stapedectomy was performed on each. In each case a homograft bone, prepared and sculptured at the Hough Ear Institute in Oklahoma, USA by the author, was then used as a prosthetic device to replace the diseased ossicle after its removal.

Results: The donated homograft bone proved to be safe with no transmission of disease; long lasting without infection, rejection, or resorption; and a good transmitter of sound with good closure of the air-bone gap. Of the 20 cases, 11 had complete closure of the air-bone gap (55%), 7 had closure air-bone gap within 10 dB (35%) and 2 showed no improvement (10%).

Conclusion: Homograft human bone is the most logical choice for ossicular reconstruction because it is the closest transplantation material to the host histologically. Current fixatives and storage materials remove the immunogenicity and so do away with the host versus graft reaction.

Keywords


Stapedectomy, Homograft

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