First experiences with a new adjustable length titanium ossicular prosthesis (ALTO)

The new length-adjustable titanium prosthesis can give good results in terms of hearing results in ossiculoplasty. The possibility to readjust the length intraoperatively was seen as a good feature.Hearing results of ossiculoplasty with a newly designed prosthesis in 14 patients were evaluated. The prosthesis is designed to allow adjustment of length in situ.A retrospective pilot study was carried out, comparing the preoperative and postoperative audiological and clinical results with an age- and pathology-matched group. The setting was the Department of Otolaryngology at the University of Heidelberg Medical Center, a tertiary referral center. In all, 14 patients underwent tympano-ossiculoplasty in which autologous reconstruction was not an option. The ossiculoplasty was performed as a therapeutic measure with the new titanium prosthesis. We evaluated the air–bone gap closure as established from preoperative and postoperative audiograms. We also looked at the clinical aspect of the tympanic membrane.The average air–bone gap came to a closure within 15 dB in 43% of the cases (6 of 14 patients). No re-perforations or extrusions of the prostheses were observed.