DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20204632

Single centre experience of ossiculoplasty using different materials: a subjective and objective evaluation

Vijay Kumar, Kranti Bhavana, Bhartendu Bharti

Abstract


Background: Chronic otitis media has serious impact over the ossicular integrity in middle ear resulting in ossicular necrosis and various grades of hearing loss along with other associated symptoms. Tympanomastoidectomy with ossicular reconstruction using various materials can improve the symptoms.

Methods: A retrospective study of 50 patients underwent tympanomastoidectomy with ossiculoplasty in Department of ENT and Head and Neck Surgery at AIIMS Patna from April 2017 to 2018.  Patients with chronic otitis media having ossicular necrosis with ABG (air bone gap) more than 25 dB were included in this study. PORP (partial ossicular reconstruction prosthesis) and TORP (total ossicular reconstruction prosthesis) were used as ossicular reconstruction after clearance of disease. This study was expressed as subjective and objective evaluation following ossiculoplasty.  

Results: Fifty patients having chronic otitis media with decreased hearing and other associating symptoms were included in this study. Preoperative air conduction threshold was 55.32 dB with preoperative ABG was 44.24 dB. Postoperative result was summarised as postoperative AC threshold was 32.72 dB with gain of 22.60 dB with ABG 25.45 dB.

Conclusions: Chronic otitis media may lead to ossicular necrosis and various grade of hearing loss. A proper technique and skilled tympanomastoidectomy with ossiculoplasty can improve the symptoms of chronic otitis media.


Keywords


Air bone gap, Air conduction, Bone conduction, Decibel, Partial ossicular reconstruction prosthesis, Pure tone audiometry, Total ossicular reconstruction prosthesis

Full Text:

PDF

References


Albera R, Canale A, Piumetto E, Lacilla M, Dagna F. Ossicular chain lesions in cholesteatoma. Acta Otorhinolaryngologica Italica. 2012;32(5):309.

Mostafa BE, Fiky LE, Hassan O. Functional results in ossiculoplasty with different titanium prostheses. Egyptian J Ear, Nose, Throat Alli Sci. 2013;14(2):79-84.

Yung M. Long-term results of ossiculoplasty: reasons for surgical failure. Otol Neurotol. 2006;27:20-6.

Fong JC, Michael P, Raut V. Titanium vsautograftossiculoplasty. Acta Otolaryngol. 2010;130(5):554-8.

Berenholz L, Burkey J, Lippy W. Total ossiculoplasty: advantages of two-point stabilization technique. Int J Otolaryngol. 2012;2012.

Gardner EK, Jackson CG, Kaylie DM. Results with titanium ossicular reconstruction prostheses. Laryngoscope. 2004;114(1):65-70.

Martin AD, Harner SG, Stephan, G, ossicular reconstruction with titanium prosthesis. Laryngoscope. 2004; 114:61-4.

Zöllner F. The principles of plastic surgery of the sound-conducting apparatus. J Laryngol Otol. 1955;69(10):637-52.

Chavan SS, Jain PV, Vedi JA, Rai D, Kadri H. Iran J Otorhinolaryngol. 2014;26(76):143-50.

Black B. Ossiculoplastyprognosis: the spite method of assessment. Am J Otol. 1992;13:544-51.

Berenholz L, Burkey J, Lippy W. Total ossiculoplasty: advantage of two point stabilization technique. Int J Otolaryngol. 2012;2012:346260.

Hillman TA, Shelton C. Ossicular chain reconstruction: titanium versus plastipore. Laryngoscope. 2003;113(10):1731-5.

Naragund AI. Ossiculoplasty with autologous incus versus titanium prosthesis: a comparison of anatomical and functional results. Indian J Otolaryngol. 2011;17:2-75.

Jha S, Mehta K, Prajapati V, Patel D, Kharidi P. A Comparative study of ossiculoplasty using various graft materials. NJIRM. 2011;2(4): 53-6.

Glasscock ME, Schwaber MK, Nissen AJ, Christiansen SG, Smith PG. Ossicular chain reconstruction: the TORP and PORP in chronic ear disease. Laryngoscope. 1983;93(8):981-8.

Gardner EK, Jackson CG, Kaylie DM. Results with titanium ossicular reconstruction prostheses. Laryngoscope. 2004;114:65-70 .

Zakzouk A, Bonmardion N, Bouchetemble P, Lerosey Y, Marie JP. Titanium prosthesis or autologous incus for total ossicular reconstruction in the absence of the stapes suprastructure and presence of mobile footplate. Eur Arch Otorhinolaryngol. 2015;272(10):2653-7.

Semaan MT, Megerian CA. The pathophysiology of cholesteatoma. Otolaryngologic Clin North Am. 2006;39(6):1143-59.

Dornhoffer JL, Gardner E. Prognostic factors in ossiculoplasty: a statistical staging system. Otol Neurotol. 2001;22(3):299-304.

Dornhoffer JL. Surgical modification of the difficult mastoid cavity. Otolaryngol Head Neck Surg. 1999;120(3):361-7.

Hazarika P, Punnose SE, Victor J, Zacharich J. Evaluation of hearing results after mastoidotympanopasty operate with and without ossiculoplasty: a prcentage change verses absolute change; a different methodology. Indian J Otol. 2018;24(3):148-56.

Vassbotn FS, Møller P, Silvola J. Short-term results using Kurz titanium ossicular implants. Eur Arch Oto-Rhino-Laryngol. 2007;264(1):21-5.