Subscribe to RSS
Titanium TORPs 15 years after implantation – what happens at the stapes footplate?
18 April 2018 (online)
Titanium TORPs were introduced into the clinical practice in the 1990 s and are now dominating the field of passive middle ear prostheses in comparison to other materials. In addition to the good acoustic properties of the filigree prostheses, the main argument for titanium as material in the middle ear is its bioinert character. Previous long-term studies have focused on the audiological results and extrusion rates of titanium TORPs, whereas the question of long-term complications in the area of the stapes footplates (e.g. osseointegration) has hardly been investigated.
Retrospectively, surgical cases from the period 2015 – 2017 were examined in which the a titanium TORP was implanted at least 15 years ago. Surgical and audiometric results were evaluated.
6 cases could be identified. There was one case of footplate perforation with partially punched-out character, but the foot of the TORP showed no bone adhesions. Another footplate was slightly thinned out and had a fine fracture line under the foot of the TORP. When correctly attached to the stapes footplate, the prostheses still showed good sound transmission even after more than 15 years.
Titanium TORP prostheses seem to be stable in terms of form and function even after more than 15 years of use in the middle ear. During revision surgery, a careful lifting of the prosthesis foot is recommended, as there may be scar fixations. There are currently no signs of osseointegration of the prosthesis foot in the area of the stapes footplate. In the case of a thinned out or fractured footplate, the use of an omega connector should be discussed, possibly together with the cartilage sandwich technique.