Zur Verträglichkeit bioinerter Aluminiumoxidkeramik im Mittelohr
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The biocompatibility of aluminium oxide implants in middle ear surgery
Scanning and transmission electronmicroscopic investigations were performed in order to study the biocompatibility of Al2O3-ceramic in the middle ear of 24 rabbits. Already after 3 weeks the implant was covered with a normal delicate mucous membrane. In electron scanning one could find a cuboidal epithelium, occasionally some ciliated cells. In our transmissionelectronmicroscopic studies the epithelial cells of the mucosa presented a normal appearance, with an intact basement membrane. We observed active fibroblasts but neither a thick fibrous layer nor giants cells. Thus signs of incompatibility could not be detected in any of the cases (up to 10 months). The subepithelial layer exhibits many normal blood vessels and some nerve fibres.
Up to now we implanted more than 150 prostheses of this bioinert material in tympanoplasties. The decisive factors speaking for the usage in middle ear surgery are: (a) optimal biocompatibility, (b) an insured and certain position, (c) after extensive shaping or after a new infection no partial resorption or atrophy of the material, (d) no fixation with the surrounding bone, (e) sufficient rigidity, but a ligament-like connection with the rest of the chain. Our preliminary results are very encouraging as far as compatibility and functional results are concerned.
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