The biocompatibility of hydroxyapatite ceramic: A study of retrieved human middle ear implants
Version of Record online: 13 SEP 2004
Copyright © 1990 John Wiley & Sons, Inc.
Journal of Biomedical Materials Research
Volume 24, Issue 4, pages 433–453, April 1990
How to Cite
van Blitterswijk, C. A., Hesseling, S. C., Grote, J. J., Koerten, H. K. and de Groot, K. (1990), The biocompatibility of hydroxyapatite ceramic: A study of retrieved human middle ear implants. J. Biomed. Mater. Res., 24: 433–453. doi: 10.1002/jbm.820240403
- Issue online: 13 SEP 2004
- Version of Record online: 13 SEP 2004
- Manuscript Accepted: 7 SEP 1989
- Manuscript Received: 2 MAR 1989
The biocompatibility of 11 hydroxyapatite auditory canal-wall prostheses and 4 hydroxyapatite incus prostheses implanted for 4 to 40 months was evaluated by light microscopy, scanning electron microscopy, transmission electron microscopy, and Röntgen microanalysis. These 15 prostheses representing 4% of 375 prostheses, had been removed because of unresolved chronic middle ear infection, residual cholesteatoma, or poor fit. The findings confirmed earlier reports on the biocompatibility of hydroxyapatite in vitro, in animals, and in man. An electron-dense layer was found at the interface with bone and fibrous tissue, and a firm bond between the ceramic and bone at the hydroxyapatite ceramic/bone interface developed. Macropores became filled with bone and fibrous tissue, and the tissue in the individual pores was interconnected. Furthermore the incus prostheses were covered with an epithelium similar to that found in the human middle ear. Findings diverging from those made in other studies were the relatively large amount of exudate in the pores, an apparent increase of degradation during infection, and the accumulation of trace elements in one of the canal-wall prostheses. In all likelihood these three phenomena may be attributed to the unfavorable conditions to which these prostheses were exposed during implantation.