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Introduction

Hydroxyapatite has been recognized as a favorable biomaterial for ossicular chain reconstruction for many years . Several characteristics account for its widespread use in ossiculoplasty: hydroxyapatite is a mineral constituent of bone with a high degree of biocompatibility, and relatively few minor complications have been reported with its use. Its biocompatibility, however, gives it the potential to osseointegrate to surrounding bone, which could lead to impaired sound conduction . Bony ankyloses of the ossicles may be congenital, infectious, or secondary to trauma or previous surgeries . This ability to form bony ankylosis with middle ear structures has been commented on in literature, however, few specific cases and outcomes have been reported.

The majority of investigations of the complications of a number of materials used in ear reconstruction have focused on rates of extrusions, biodegradation, and foreign body reactions . This report concerns 2 cases of hydroxyapatite prosthesis ankylosis: the first to the fallopian canal and the second to the scutum. The fixation to the fallopian canal poses a unique challenge to surgical management secondary to the vulnerable location of this ankylosis.