[The experience with the reconstruction of the superoposterior wall of the external auditory meatus during stapedoplasty].

The objective of the present study was to improve the effectiveness of stapedoplasty by developing the method for the prevention of the formation of retraction pockets in the tympanic membrane and cicatrical fixation of auditory ossicles. A total of 60 patients presenting with grade I-II otosclerosis and conductive or mixed-type hearing impairment were surgically treated during the period from 2008 to 2014. Twenty four of these patients had undergone stapedoplasty in the preceding period in different clinics that either failed to improve their conditions or resulted in their deterioration. A new method was proposed for the reconstruction of the superoposterior wall of the auditory canal during stapedoplasty that consists of the replacement of the removed fragment by the last 150-200 mcm ultrathin allocartilaginous plate. This plate prevented the subsequent retraction of the superoposterior portions of the tympanic membrane and its fusion with either the long process of the anvil bone or the prosthetic ring. The method of this operation is described. The analysis of long-term results of the treatment confirmed the high effectiveness of the proposed approach.

[The possibilities for the application of the fluoroplast-based prostheses with a diamond-like carbon nanocoating in ear surgery (an experimental study)].

The objective of the present study was to elucidate general and local characteristics of the tissue reactions to the implantation of radiation-modified polytetrafluoroethylene (PTFE)-based fluoroplast F-4PM20 with a diamond-like carbon (DLC) nanocoating or with the diamond-like carbon coating containing the dispersed nano-sized silver particles to the experimental animals (rats). A total of 150 inbred white rats were included into the experiment; they were divided into 3 groups comprised of 50 animals each. The rats in group 1 were implanted with the 5 nm thick strips of fluoroplast F-4PM20 having the diamond-like carbon nanocoating. The animals of group 2 were implanted with the same material containing nanoparticles of chemically pure silver dispersed in the coating, those in group 3 (controls) were implanted with the fluoroplast F-4PM20 without a coating. The animals were sacrificed on days 7, 21, 30, and 60 days after the onset of the experiment. The tissues surrounding the implant as well as heart, lung, spleen, liver, and kidney tissues were taken for the histological study. The local reactions of different tissues were found to be uniform even though there was an apparent tendency toward the less pronounced granulation and scarification processes in the animals implanted with the diamond-like carbon coating containing the dispersed nano-sized silver particles. In none of the groups, the animals exhibited statistically significant lymphoid tissue hyperplasia in the spleen which suggested the activation of the immune system in response to implantation. It is concluded that the PTFE-based fluoroplast F-4PM20 implants with the 5 nm thick DLC coating and a similar coating containing the dispersed nano-sized silver particles can be applied for middle ear reconstructive surgery, being a histologically compatible material that does not cause an inflammatory degenerative response of the tissues.