The need for better implant materials was a stimulus for the increa-
sing knowledge of Biomaterial Scientists. Different surgical disciplines
were very successful in the use of prostheses, especially because they
based their surgery on a good cooperation with fundamental scientists.
The use of alloplastic implant materials in the reconstruction of the
middle ear has not always been successful. We all know the initial suc-
cess in the sixties and the disappointments after short term follow-up
periods. Because of these failures, Otology missed contact with the new
developments in Biomaterial Science. However, we must realize that in
the reconstruction of a sound conducting system our most successful
results are achieved with alloplastic implants. John Shea introduced the
use of Teflonprostheses in the restoration of hearing in otosclerosis
and ever since this has been the most rewarding reconstructive middle
ear opera- tion. With the development of the intact canal wall
techniques and the use of homologous implant materials the problems of
middle ear surgery see- med to be solved. However, we now know that
closed techniques have dis- advantages after longer post-operative
periods and the use of homologous implant materials give problems.
Collection of these implants is not al- ways easy and the preservation
is still in discussion. Furthermore, pro- blems of resorption, rejection
or fixation give uncertain post-operative results. Middle ear prostheses
of different new implant materials are promoted by industry and good
results are published, but also disappointments after shorter or longer
periods.
