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Transplants and Implants in Otology III

edited by: M. Portmann & P. Boudard & D. Portmann

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Publication details: Book. 1996. xx and 400 pages. Publication date: 1996-05-31. 175 figures and 67 tables. Hardbound.

ISBN: 978-90-6299-142-6 (ISBN 10: 90-6299-142-4; Kugler Publications)



It was with particular pleasure that I welcomed the Third International Symposium on Transplants and Implants in Otology in Bordeaux, along with its Co-Presidents: the Italian team, consisting of Professors G. Babighian, C. Zini, founders of the First Congress in Venice in 1987, and the Japanese team, with Professors J.I. Suzuki, N. Yanagihara, the key players in the Second Congress in Matsuyama in 1991. Otology has undergone profound changes during the last 50 years, and an essential part of these changes has been the use of transplants and implants. The essential history of the surgery of our specialty belongs to the second half of the last century. It began with surgical indications that were rudimentary, and surgical techniques that, although demanding, were carried out with crude instruments, the hammer, gouge, and chisel, and with no effective magnification. The second period of development began in 1953, when the operating microscope first appeared on the market. From that moment, surgical instruments started to become more sophisticated. Progress in investigation (audiometry, vestibular testing), in imaging, and in medical treatment, all helped to refine the indications for surgery and to extend them into the realm of disorders of function. 'Inactive' implants and transplants of all sorts were tried out, and were presented in a flurry of publications and with very variable results, ossicles, materials for reconstructing the meatal wall and for obliterating cavities, etc. Slowly these materials, their shape, and their biological compatibility improved, until we arrived at the unparalleled excellence of today. The third period has made its gradual appearance during the last twenty years, with the introduction of 'active' materials which have an inherent source of energy. The cochlear implant is the foremost example of this type, as are hearing aids introduced into the mastoid or middle ear, with increasing success. The era of 'active' implants is thus upon us, and its momentum will not slow down in the last years of this century and the beginning of the third millennium. During the course of the administrative session at Matsuyama in 1991, I was given the honor of hosting the Third Congress. Our Scientific Committee has organized plenary sessions lasting half an hour, with suitably experienced speakers, followed by panel discussions and round tables which cover the main subject matter. Most specialists of international repute have responded to our invitation. We have received more than 120 communications, and these have been distributed among the appropriate specialized sessions. I would like to be allowed to extend my thanks to the pharmaceutical and instrumental companies, to the teams of the G. Portmann Institute and finally to all the participants, gathered together from all over the world. Their attendance was the guarantee of the quality and success of what is literally a forum on the subject, representing the current state of the art. But progress will not stop here, and this Symposium was in no way the 'last word' on the subject, nor even a musical pause in the continuing rondo of our research efforts. Research workers have even been able to demonstrate that the sensory organs are capable of regeneration, a notion that flies in the face of all received wisdom to date, and which opens up whole new vistas on the horizon of rehabilitation of the organs of sensation. The last word must be that of medical ethics; however great may be our desire to do even more and even better, we must never lose sight of the fact that our research work has moral limits, dictated by the respect that we all owe to our patients.

Bordeaux June 1995

A. Portmann, MD

Table of Contents

Table of Contents

List of contributors


Special lecture: Sensorial regeneration: present perspectives
Jean-Marie Aran

The use of human osteoprogenitor cells in bone repair
J. Amédée, C. Faucheux, S. Verrier, R. Bareille and Ch. Baquey

Quantifying healthy ear canal geometry using magnetic resonance imaging
A. W. Blayney, J.P. Stack, G.J. McAvoy and H.J. Rice

Calcium-phosphate ceramic as a bone substitute
Guy Daculsi

Biomaterials in ossiculoplasty
M. Gersdorff

Material retrieved from patients after reconstruction
J.J. Grote

Results with the total artificial middle ear
J.J. Grote

The soft tissue reaction around clinical long?term percutaneous titanium implants:
transmission electron microscopic observations
K.M. Holgers, P. Thomsen, A. Tjellström and L.E. Ericson

Biocompatibility studies of implants for reconstructive middle ear surgery: scientific basis
Klaus Jahnke, Philipp Dost and Martin Schrader

Experimental otitis media effusion
Miroslav B. Krouk, Igor I. Gritsko and Oleg S. Tchyz

Esterified hyaluronan (Otosponge) in the middle ear - a new tool for otosurgery?
Claude Laurent, Ove Söderberg and Sten Hellström

The value of an implantable adhesion barrier, Interceed, in the prevention of adhesion formation following tympanoplasty
O. Michel, R. Hess and P. Neugebauer

Tympanic membrane damage and repair as analysed by the finite element method
Keith R. Williams, Alexander W. Blayney and Tristram H.J. Lesser

A dynamic and harmonic damped finite element ? analysis of a stapes prosthesis replacement
reconstruction of the middle ear
Keith R. Williams and Alexander W. Blayney


The evolution of treatment methods for the absent pinna: reconstructive and prosthetic
Philippe Boudard and Didier Portmann

Differential indications for otopoiesis and ear epithesis
F. Disant, P. Céruse and C. Bugeaud

Some considerations regarding the rehabilitation of patients with congenital ear malformations using the osseointegration concept
Gösta P.B. Granström, Kerstin M. Bergström and Anders M.R. Tjellström

Immediate surgical and post-surgical prosthetic rehabilitation in maxillofacial region surgery
övünç Günhan, Bülent Karci and Engin Aras

Combined esthetic and functional ear reconstruction
Rodolphe Meyer

Clinical results of auricular prosthesis in Nijmegen
E.A.M. Mylanus, C.W.R.J. Cremers, N. Postema, M. van Leer and P. Rijsemus

Surgical treatment of microtia
José Antonio Rivas, José Alberto Prieto and Fabio Campo

Surgical reconstruction in atresia cases
José Antonio Rivas


Tympano-ossicular allograft tympanoplasty: benefits, ethical and forensic aspects
B. Ars

Tympanoplasty results using Zini's modified method with a preformed tympanoplastic flap
Vladimir Hofman

Autologous fibrin glue in middle ear functional microsurgery
Tayfun Kirazli, Vecihi Bilgen, Büdent Karci, Sezaver Alper and Orhan Cura

The tympanic Endopatch - a new tympanic membrane: clinical experience
M. Négrevergne, G. Lacher, J.P. Bébéar, N. Bozon and M. Rabaud

Allografts in otology - potential contamination by prions: present state of knowledge and
practical consequences
Ch. Martin, M. Detsouli, J.M. Prades, F. Lucht, M. Durand and P. Bertholon

Mastoid and middle ear reconstructive surgery in chronic infectious disease, using
autologous graft tissue: a 22-year experience
G.F. Quiros, I. Subhich, J. Hernandez and E. Quiros

Bellucci's classification system and postoperative healing in tympanoplasties and stapedectomies
Konrad Schwager, Joachim Müller and Sibyl Mittler

Allografts and AIDS in otology: recommendations for tissue banking
J.E. Veldman, M.H.J.M. Majoor, F. Meeuwsen, E.H. Huizing and I. Gerlinger


Cartilage heterografts in middle ear surgery
Paolo Bruschini, Stefano Berrettini, Stefano Sellari-Franceschini, Giovanni Segnini
and Franco Piragine

Anatomical and functional results in surgery of chronic otitis media: our experience
M.A. Crovetto de la Torre, L.M. Fiz Melsió and J.M. Sánchez Fernandez

Tympanoplasty revision with material replacement
Rafael Gomez-Ullate, Carlos Ruiz, Fernando Cristobal, Mauricio Ledesma and Fernando Olaizola

Reconstruction of the ossicular chain with bioinert ceramics
K. Jahnke

Acoustic aspects of passive middle ear prostheses
R. Lehner, C. Burkhardt and H.P. Zenner

Comparative study and clinical results obtained by means of lyophilized bone allografts
and by incus transposition (102 cases)
J.P. Maisin, V. van Hellemont, A. Benjaballah, J.C Minet, J.P. Monnoye, P.J. Verheyden
and P. Levie

Ossicular reconstructions using an incus-stapes 'Sleeve' assembly
R. P. Mills

Ossicular reconstruction using dental homograft: long-term follow-up of a pilot study
Christopher R. Pearson, Hugh J. Cox, Michael C. Frampton and Richard J.N. Garth

Repair of the long process of the incus: bone pate and ionomeric bone cement compared
James M. Robinson

Long-term follow-up study of ossicular reconstruction using hydroxyapatite prostheses
Takayuki Shinohara, Tadahiko Saiki, Kiyofunii Gyo and Naoaki Yanagihara

Ossicular reconstructions with a Politef implant malleus attachment piston
R.A. Tange

TORPs and PORPs in tympanoplasty
F. Trabalzini, G. Babighian and S. Albu

Ossiculoplasty with J.B. Causse composite prostheses: our experience in 749 cases
Robert Vincent, Benoit Gratacap and Geoffroy Vandeventer


Reconstruction of the posterior wall of the external auditory canal
B. Ars

A new method for reconstruction of the external ear canal in congenital aural atresia:
free skin graft prepared from penile prepuce
Orhan Cura, Tayfun Kirazh, Fazil Apaydin and Fikri öztop

Costal cartilage in middle ear surgery
M. Decat, M.A. Polet and M. Gersdorff

Surgical mastoid cavity obliteration by calf bone collagen
Stefano Galli

Reconstruction of middle ear, mastoid, and ear canal, and restoration of hearing after
canal-wall down mastoidectomy: ten year experience
Juan J. Garro

Reconstruction of the external ear canal with titanium
Guy Lacher

Reconstruction of the ear canal wall
J. Magnan, A. Chays, E. Pencroffi, P. Locatelli and M. Bruzzo

Open technique with obliteration of mastoid cavities: long-term morphological and functional results
Ch. Martin, M. Detsouli, J.M. Prades and N. Merzougui

Middle ear and external auditory canal reconstruction with Triosite
Fernando Olaizola , Ramón Arroyo, Hugo Ballivián and Mauricio Ledesma

Tympanoplasty with temporary removal of the posterior bony canal wall
Youri A. Soushko, Oleg N. Borissenko and Grygori S. Polisthuk

Reconstruction of the ear canal wall using a mixture of bone chips and pate
Etsuo Yamamoto, Yasuyuki Tasaka, Tomoko Okumura and Tetsuya Ogata


Special lecture: Lateral approaches to the skull base
R. Charachon

Reconstruction of the skull base with ceramic plates: long-term follow-up
Klaus Jahnke and Philipp Dost


Preoperative computed tomography in patients requiring a BAHA Dentascan program
B. Ars and J. Casselman

The Danish BAHA file: preliminary results
P. Bonding, L.H. Nielsen, U. Pedersen and T. Brask

BAHA: experience from Bordeaux
Didier Portmann, Michel Bourdin and Philippe Boudard

What happens outside the OR? Experiences of a management project for children with
bilateral microtia by means of BAHA and aural epitheses
Matti Raivio, Eero Akaan-Penttilä, Mirja Ikonen and Karin Tuomala

The bone-anchored hearing aid (BAHA) versus air-conduction hearing aids
Ad F.M. Snik, Emmanuel A.M. Mylanus and Cor W.R.J. Cremers


Special lecture: Is a totally implantable hearing aid realistic?
Jun-Ichi Suzuki and Kazuoki Kodera

Special lecture: Partially implantable hearing aid - a device using a piezoelectric middle
ear prosthesis: the Japanese experience
Naoaki Yanagihara, Jun-Ichi Suzuki, Yasuyuki Hinohira, Kiyofumi Gyo and
Kazuoki Kodera

Development of an implantable piezoelectric vibrator for middle ear implant: state of
the research program
T. Dumon, O. Zennaro, V. Darrouzet, J.M. Aran, J.P. Bébéar

Totally implantable hearing device
Edmundas Lenkauskas

Hearing acuity of the implantable hearing aid
T. Saiki, K. Gyo and N. Yanagihara

Implantation of a partially implantable piezoelectric middle ear implant in postoperative cases
Takao Yabe, Eiyu Takeda, Kazuoki Kodera and Jun-Ichi Suzuki


Special lecture: Multicenter evaluations of speech perception in adults and children with
the Nucleus (Cochlear) 22-channel cochlear implant
Graeme M. Clark, Richard C. Dowell, Robert S. Cowan, Brian C. Pynian and
Robert L. Webb

Electrode design and sound signal processing: versatility of the French multichannel cochlear implant
C.H. Chouard, M. Ouayoun and B. Meyer

Twenty years' experience with the cochlear implant
C.H. Chouard

Revision of a cochlear implant
Kiyofumi Gyo, Shinsei Nishihara, and Hidemitsu Sato

Measurement of the stapedius reflex using a simplified device
Ernst Lehnhardt, Emanuel Klier, Jaroslava Prihodová, Zdenek Kabelka and Miroslav Oklusky

The COMBI-40 high-performance cochlear implant
Albert Maltan and Inge Hochmair

The AllHear cochlear implants
Pedro L. Mangabeira?Albernaz

Evolution of cochlear implant devices in 1995
Pierre B. Montandon

Intracochlear implants: comparative results
M. Négrevergne, D. Portmann, M. Bourdin and P. Lagourgue

The cochlear implant in Colombia: experience with the surgical technique
José Antonio Rivas

The value of stapedius reflex measurements determined during cochlear implant surgery
Ad FM. Snik, L.H.M. Mens, J.B. Hinderink, S. van den Borne, J.P.L Brokx
and P. van den Broek

Multichannel cochlear implant in patients with ossified cochlea: interest in the optimization
of frequential selectivity of speech signals with the Digisonic device
Eric Truy, Stéphane Gallego, Christian Berger-Vachon and Alain Morgon

Concluding remarks: Ethics and a look into the future
M. Portmann

Index of authors

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