Kurz Prothesis

Kurz Prothesis-48
Numerous technical advances have improved hearing results and long-term results.With the major innovation of utilizing cartilage as an interface between the prosthesis and the tympanic membrane, extrusions have been reduced.

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Although these grafts could be treated with autoclaving or formaldehyde to eliminate the risk of cholesteatoma or infectious transmission, these processes created a greater burden in using homografts.

Special storage requirements also increased the expense and led to decreased popularity.

These pores in the Proplast material also allowed host fluids to infiltrate the prosthesis and facilitate the acceptance of the prosthesis.

The unique problem with this prosthesis was its Teflon shaft, which was not amenable to contouring.

Aside from the residual microscopic cholesteatoma disease, once modified, the malleus or incus might not be long enough, particularly in total ossiculoplasty [2].

Homografts were one of the first reconstructive options but later fell out of favor due to the increased resorption and possible infectious transmission [3].In a large review of homografts by Chiossone [4], the functional results were understood to be inferior to middle ear reconstruction undertaken with prostheses.In over 400 cases the incus was most commonly used with the malleus used nearly as often.The early results were promising, with understanding that the grafts would become part of the host environment.Fusion of the bone graft to the malleus and stapes or footplate should achieve perpendicular action with good sound transmission [8].Use of homografts requires special banks that might not be widely available.The 1970s brought additional interest into trying to overcome the deficiencies of the autograft, homograft, and plastic implants of the 1950s and 1960s.In spite of all the advantages of Plastipore, it was understood that the fibrous unions between the shaft and the footplate could also occur between the shaft and the promontory, Fallopian canal and scutum.This fixation to surrounding bone was a significant problem with homograft and allograft ossicles.Concern for reimplantation of cholesteatoma when using the incus eventually led to the decline in its popularity.In addition, the time involved in drilling the incus to modify the ossicle was seen as a disadvantage.


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