The Titanium Angular Clip Prosthesis for Ossicular Chain Reconstruction: Long-Term Results

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Abstract
Objectives: To describe the long-term results of the titanium angular clip prosthesis 10 years after its initial description. Study Design: Clinical retrospective study. Setting: Tertiary referral center. Patients: Sixty three patients with isolated defects of the long process of the incus where the ossicular chain was reconstructed by a titanium angular clip prosthesis. Interventions: Therapeutic. Main Outcome Measures: The mean air-bone gap was calculated over the frequencies of 0.5, 1, 2, 3, and 4 kHz. Results: The placement of the prosthesis was straightforward in all patients, without any complication. During the first follow-up visit after 3 weeks (n = 61) the mean air-bone gap (ABG) was reduced by 10 dB HL, and from 24 dB HL preoperatively to 14 dB HL. At the long-term follow-up appointment—4 years after implantation (n = 29)—the mean ABG was still reduced by 8 dB HL, from a mean of 26 dB HL preoperatively to 18 dB HL. Conclusion: The use of the titanium angular clip prosthesis is a safe and reliable way to bridge an isolated erosion of the long process of the incus, leading to significant and long-lasting improvement of the ABG both in the short and long-term follow-up. A similarly large improvement of the sound transmission can be achieved both in patients with a Type A and a Type B/C tympanogram.

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