Histological reaction to hydroxyapatite in the middle ear of rats

Abstract Objective: Present study was performed to evaluate the histological response of rat middle ear mucosa following implantation of Apaceram® granules, a synthetic dense hydroxyapatite [Ca 10 (PO 4 ) 6 (OH) 2 ], prepared from commercially available synthetic auditory ossicle, and to assess the precise histological response of the rat middle ear to implantation of Apaceram® granules, by microscopic examination of mucosal tissue at various time points after implantation. Methods: Apaceram® granules were implanted in the temporal bulla of 32 rats. As control, sham surgery was performed in a group of ten rats. Bulla specimens were removed at 1, 3, 7, 14, and 30 days after surgery in the implant and control groups, and at 90, 180 and 300 days in the implant group. Specimens were decalcified, sectioned at a thickness of 6 μm, and stained with haematoxylin and eosin, and Mallory's azan for histological examination of mucosal tissue. Results: Evidence of inflammatory reaction was slightly greater in the implant group than in controls. Lymphocyte and macrophage counts were higher in the implant group 1 day after surgery, but decreased to similar levels by day 3, and continued to decrease thereafter, and few were observed in the implant group at 300 days. Neutrophils observed at 1 day after surgery were not evident in either group at 3 days. Gradual fibrosis development continued in both groups over all time points studied. Foreign body giant cells were never observed in either group. No bony reaction was observed in any specimen. Conclusion: The results of this study suggest that Apaceram® is biocompatible and suitable for reconstructive ear surgery.