Abstract
Objective: Microbial biofilms are commonly found on ossicular chain reconstruction prostheses (ORPs). They have been implicated as a cause of suboptimal hearing outcomes. The purpose of this study was to determine which middle ear pathogens might be involved with ORP biofilms and ORP problems, such as scarring or extrusion. Method: ORPs were explanted at the time of revision surgery and analyzed for microbial colonization using quantitative polymerase chain reaction (qPCR) with pathogen-specific primers for Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Candida albicans, Candida parapsilosis, and Aspergillus niger. Results were correlated with the otologic status. Results: The majority of ORPs (19 of 21) tested positive for at least one pathogen. On average, each ORP tested positive for the presence of 2 pathogens. Twelve tested positive for S aureus, 10 for H influenzae, 9 for P aeruginosa, and 1 for S pneumoniae. No samples revealed C albicans, C parapsilosis, or A niger. Hearing, cholesteatoma, presence of effusion, extent of middle ear scarring, and extrusion did not appear to correlate with the presence of specific pathogens. Conclusion: ORPs commonly harbor polymicrobic bacterial colonies or biofilms. Fungal pathogens are not commonly found on ORPs. While the presence of these biofilm-forming organisms is evident, it is unclear whether these pathogens play a role in unfavorable outcomes with middle ear reconstruction.
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