Transmeatal procurement of allograft tympano-ossicular systems : preliminary report

The first successful clinical use of allogeneic tympano-ossicular systems for reconstruction of the middle ear in chronic otitis media was established by Jean Marquet in 1963. Allograft tympano-ossicular systems (ATOS) were originally intended to restore the original anatomical and physiological situation of the middle ear, allowing extirpation of tissues affected by chronic otitis media with or without cholesteatoma. ATOS have demonstrated excellent biocompatibility, even in chronically infected environment. Its value was universally recognised and ATOS were widely used in the nineties. However, concerns on safety regarding transmissible diseases, such as human immunodeficiency virus infection (HIV), limited its use. When the relationship between variant Creutzfeldt-Jakob’s disease (vCJD) and bovine spongiform encephalopathy (BSE) was elucidated, measures taken during the BSE endemy lead to the discontinuation of ATOS in many countries. In our department, ATOS are still the preferred material for reconstruction of the tympanic membrane and ossicular chain. Meanwhile, new European Union (EU) regulations on tissues and cells endeavour quality assurance, traceability and safety procedures to reduce the risk of transmitting disease. Recently, Van Rompaey et al. have demonstrated that running an ATOS tissue bank, complying with these EU regulations, is possible.