Abstract
Background: Situation of incus erosion is common while performing tympanoplasties for cases of chronic otitis media. As none of the available techniques is said to be gold standard, a cost effective and easily available partial ossicular replacement prosthesis is employed and the postoperative hearing outcome is presented.
Objectives: To assess the hearing results of ossiculoplasty using partial ossicular replacement prosthesis during tympanoplasty.
Methodology: A descriptive cross-sectional study was carried out in a tertiary referral hospital of Nepal from June 2018 to September 2019. Twenty-eight consecutive patients who underwent tympanoplasty for chronic otitis media (inactive/mucosal) with incudostapedial discontinuity were operated using polytetrafluoroethylene partial ossicular replacement prosthesis without removing the incus. Pure tone averages, air-bone gap and air conduction gain were calculated pre and post-operatively.
Results: There was no extrusion of prosthesis. The post-operative air-bone gap less than 20 dB was achieved in 23 (77%) cases. All the patients had post-operative air-bone gaps of ?25dB. There were no major complications.
Conclusion: Polytetrafluoroethylene partial ossicular replacement prosthesis is a safe, reliable and efficient alternative for ossiculoplasty during tympanoplasty surgery.
References
Bauer M. Ossiculoplasty: autogenous bone grafts, 34 years experience. Clin Otolaryngol Allied Sci. 2000;25(4):257-63.[PubMed | DOI]
Frootko NJ. Reconstruction of the middle ear. In: Kerr AG, editor. Scott Brown’s Otolaryngology. Great Britain: Hodder Arnold; 1997;3(6):8-26. [DOI]
Hall A, Rytzner C. Vitality of autotransplanted ossicles. Acta Otolaryngol Suppl. 1960;158:335-40. [PubMed | DOI]
Varshney S, Nangia A, Bist SS, Singh RK, Gupta N, Bhagat S. Ossicular Chain Status in Chronic Suppurative Otitis Media in Adults. Indian J Otolaryngol Head Neck Surg. 2010;62(4):421-6. [PubMed | DOI]
Baylancicek, S, Iseri, M, Topdag, DO, Ustundag E, Ozturk M, Polat S, Uneri C.Ossicular reconstruction for incus long-process defects: bone cement or partial ossicular replacement prosthesis. Otolaryngol Head Neck Surg. 2014;151(3):468-72.[PubMed | DOI]
American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc.Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. Otolaryngol Head Neck Surg. 1995;113:186-7. [PubMed | DOI]
Vincent R, Rovers M, Mistry N, Oates J, Sperling N, Grolman W. Ossiculoplasty in intact stapes and malleus patients: a comparison of PORPs versus TORPs with malleus relocation and Silastic banding techniques. OtolNeurotol. 2011;32:616-25.[PubMed | DOI]
Yung M, Vowler SL. Long-term results in ossiculoplasty: an analysis of prognostic factors. OtolNeurotol. 2006;27:874-81.[PubMed | DOI]
Chavan SS, Jain PV, Vedi JN, Rai DK, Kadri H. Ossiculoplasty: A Prospective Study of 80 Cases. Iran J Otorhinolaryngol. 2014;26(76):143-50.[PubMed]
Hess-Erga J, Møller P, Vassbotn FS. Long-term hearing result using Kurz titanium ossicular implants. Eur Arch Otorhinolaryngol. 2013; 270:1817-21.[PubMed | DOI]
Berenholz LP, Burkey JM, Lippy WH. Short- and long-term results of ossicular reconstruction using partial and total plastipore prostheses. OtolNeurotol. 2013;34:884-9.[PubMed | DOI]
Yung M. Long-term results of ossiculoplasty: reasons for surgical failure. OtolNeurotol. 2006;27:20-6. [PubMed | DOI]
Vlaming MS, Feenstra L. Studies on the mechanics of the reconstructed human middle ear. Clin Otolaryngol. 1986;11:411-22.[PubMed | DOI]
Brackmann DE, Sheehy JL, Luxford WM. TORPs and PORPs in tympanoplasty: a review of 1042 operations. Otolaryngol Head Neck Surg. 1984;92:32-7.[PubMed | DOI]
Goldenberg RA. Hydroxylapatite ossicular replacement prostheses: preliminary results. Laryngoscope. 1990;100(7):693-700.[PubMed | DOI]