Ossicular chain damage from chronic ear disease is a significant problem in the Australian population. The ideal ossicular chain reconstruction prosthesis has yet to be defined. This paper examines, for the first time, the use of a titanium prosthesis for ossicular chain reconstruction in Australian patients.

Retrospective chart review.

All patients undergoing ossicular chain reconstruction with a titanium prosthesis between 1 February 2002 and 31 March 2007.

Results showed a low complication rate, with only one extrusion out of 55 cases (1.8 per cent). Successful rehabilitation of conductive hearing loss (i.e. to ≤20 dB air–bone gap) was obtained in 85 per cent of the partial ossicular chain reconstruction group and 77 per cent of the total ossicular chain reconstruction group. Pure tone thresholds improved by an average 18 dB in the partial reconstruction group and 25 dB in the total reconstruction group.

Titanium is an ideal material for ossicular chain reconstruction due to its ease of insertion, low rate of extrusion and good functional results.

This paper reviews our experience of ossicular chain injuries following head trauma treated at Groote Schuur Hospital, Cape Town, South Africa.

We performed a retrospective chart review of all patients with a history of head trauma and a conductive hearing loss who had undergone exploratory tympanotomy. Sixteen patients were included in the study.

Injury was most common at the incudostapedial joint (63 per cent). Disarticulations of the icudostapedial joint were treated with cartilage interposition in all cases. Audiography showed an improvement in 12 of the patients, with an average improvement of 35 dB.

We discuss the various options available to the otologist to repair ossicular disruptions after trauma. In this series, cartilage autografts were used in most incudostapedial joint injuries, with excellent closure of the air–bone gap.

Cartilage interposition was a very successful method of repairing incudostapedial joint dislocation in this series, at short term follow up.

This study aimed to investigate the outcomes of autologous ossiculoplasty following temporal bone fracture.

We analysed 10 patients who underwent autologous ossiculoplasty following temporal bone fracture from 1993 to 2006. Average results for air conduction, bone conduction and air–bone gap were calculated, using both a three- and a four-frequency average, in order to evaluate the effect of the operation.

The average follow-up time was 24.4 months. Dislocation of the incus was the most common operative finding. The average three- and four-frequency post-operative air–bone gaps were 12.0 dB (standard deviation 8.3) and 13.8 dB (standard deviation 7.7), respectively. The average air–bone gap improvements were 24.5 dB (standard deviation 13.8) and 24.4 dB (standard deviation 12.1), respectively. Eighty per cent (eight of 10) of the patients had socially acceptable hearing in the operated ear. However, only 50 per cent achieved closure of the air–bone gap to within 10 dB.

Methods of maximising the stability of the reconstructed ossicular chain should be further studied.