Ossiculoplasty: autogenous bone grafts, 34 years experience

A series of 785 bone grafts between the tympanic membrane and head of the stapes were performed between 1964 and 1998. Ears were divided into 'normal tympanic membrane','stage I' and 'stage II' groups, in which the averages of the last postoperative air-bone gaps were 13.2, 18.7 and 18.1 dB, respectively (revision operations included). In the same order 43%, 26% and 23% of the ears showed air-bone gaps equal to or smaller than 10 dB; 85%, 61% and 67% equal to or smaller than 20 dB. Failures specific to the bone columella necessitated nine revision operations (eight for osseous fixation and one for atrophy). There have been no extrusions so far. Although, in the light of the literature the results are acceptable there is room for improvement.