“…Multiple studies attained success rates of 66–74 per cent for autograft, 54–86 per cent for partial ossicular reconstruction prosthesis and 51–55 per cent for total ossicular reconstruction prosthesis ossiculoplasty. 2,8–14 Ossicular chain reconstruction is commonly conducted during tympanoplasty for atelectasis and cholesteatomaTraditionally, total or partial ossicular reconstruction prostheses are used, or the incus is removed, sculpted and re-insertedThis study shows that an unsculpted incus gives comparable results to prostheses or sculpted incusIt is an especially useful technique in hospitals without access to prostheses or a drill for incus sculptingGiven that the incus is unmodified, this procedure is easier to perform…”
Objective
To evaluate patients’ hearing outcomes after ossicular chain reconstruction using unmodified autologous incus.
Methods
A single-centred, retrospective study of patients who underwent incus interposition between June 2010 and October 2017 was conducted at a Dutch secondary referral centre. This paper describes a chart review of patients who presented with erosion of the long process of the incus due to atelectasis or cholesteatoma who were treated with an unmodified incus interposition. The main outcome measures were: post-operative air–bone gap and level of air–bone gap closure.
Results
Thirty-three ears of 32 patients were included. Follow-up duration ranged from six weeks to seven years. A mean post-operative air–bone gap under 25 dB was considered successful; this was achieved in 25 patients (76 per cent), 20 (91 per cent) in the partial ossicular reconstruction prosthesis group and 5 (45 per cent) in the total ossicular reconstruction prosthesis group. This difference was statistically significant (p = 0.007).
Conclusion
Successful preservation and improvement of hearing was observed in most patients. As expected, the closure rate in the partial ossicular reconstruction prosthesis group was better. Longer follow-up studies with larger case numbers are needed to assess whether further reconstruction techniques are necessary.
“…Multiple studies attained success rates of 66–74 per cent for autograft, 54–86 per cent for partial ossicular reconstruction prosthesis and 51–55 per cent for total ossicular reconstruction prosthesis ossiculoplasty. 2,8–14 Ossicular chain reconstruction is commonly conducted during tympanoplasty for atelectasis and cholesteatomaTraditionally, total or partial ossicular reconstruction prostheses are used, or the incus is removed, sculpted and re-insertedThis study shows that an unsculpted incus gives comparable results to prostheses or sculpted incusIt is an especially useful technique in hospitals without access to prostheses or a drill for incus sculptingGiven that the incus is unmodified, this procedure is easier to perform…”
Objective
To evaluate patients’ hearing outcomes after ossicular chain reconstruction using unmodified autologous incus.
Methods
A single-centred, retrospective study of patients who underwent incus interposition between June 2010 and October 2017 was conducted at a Dutch secondary referral centre. This paper describes a chart review of patients who presented with erosion of the long process of the incus due to atelectasis or cholesteatoma who were treated with an unmodified incus interposition. The main outcome measures were: post-operative air–bone gap and level of air–bone gap closure.
Results
Thirty-three ears of 32 patients were included. Follow-up duration ranged from six weeks to seven years. A mean post-operative air–bone gap under 25 dB was considered successful; this was achieved in 25 patients (76 per cent), 20 (91 per cent) in the partial ossicular reconstruction prosthesis group and 5 (45 per cent) in the total ossicular reconstruction prosthesis group. This difference was statistically significant (p = 0.007).
Conclusion
Successful preservation and improvement of hearing was observed in most patients. As expected, the closure rate in the partial ossicular reconstruction prosthesis group was better. Longer follow-up studies with larger case numbers are needed to assess whether further reconstruction techniques are necessary.
“…15 Therefore, Wu et al 8 used the hearing result at the high frequency of 4.0 kHz for representing the material efficacy for autologous ossiculoplasty and described that 90% of the patients using autografts had closure of the ABG within 20 dB, with a similar effect of titanium, especially in terms of high-frequency improvements at 2-year follow-up. 8 Even more, Sterrer and Loader 16 retrospectively analyzed large sample sizes of 115 patients with COM or cholesteatoma receiving incus interposition graft (N = 62) or PORP (N = 53), and demonstrated incus autograft may have better outcomes than PORP in specific frequencies of 0.25, 1.0, 2.0, and 3.0 kHz. In our study, both the autologous incus and titanium prosthesis groups showed significant hearing benefits in terms of the AC and ABG at 4.0 kHz and the 4-frequency averages, indicating that the material efficacy was similar in the 2 groups.…”
Objectives: To investigate the etiology and ossicular pathology of traumatic ossicular injury in Taiwan and examine the hearing outcomes and predictive factors between the titanium prosthesis and autologous incus groups. Methods: We retrospectively analyzed patients with traumatic ossicular injury from 2011 to 2020 in Taiwan. Patients were divided into the titanium or autologous group according to the surgical materials used. The audiometric outcomes and predictive factors of ossiculoplasty were analyzed between groups. Results: Twenty patients with ossicular chain discontinuity were enrolled (8 in the titanium group and 12 in the autologous group). The postoperative hearing threshold (26.6 ± 8.9 dB) and air-bone gap (10.3 ± 5.6 dB) improved significantly compared with the preoperative hearing threshold (50.7 ± 13.3 dB) and air-bone gap (29.9 ± 11.0 dB). The improvements in the hearing threshold and air-bone gap were not significantly different between the titanium and autologous groups. Our patients presented an improvement in hearing restoration with 65% closure of the air-bone gap in 0 to 10 dB range and 30% in 11 to 20 dB range, without sensorineural hearing loss during surgery. Univariate regression analysis revealed that vertigo, benign paroxysmal positional vertigo, and temporal bone fracture may serve as negative factors influencing the air-bone gap gain. Conclusions: Ossiculoplasty with both titanium prosthesis and autologous materials demonstrated favorable hearing recovery in traumatic ossicular injury. Vertigo, benign paroxysmal positional vertigo, and temporal bone fracture may serve as negative predictive factors of the hearing benefit after surgery.
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