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Updated: Jul 1, 2026

Techniques of Endoscopic Ossiculoplasty
09:07

Techniques of Endoscopic Ossiculoplasty

Published on: January 26, 2024

Ossiculoplasty with the use of autografts and synthetic prosthetic materials: a comparison of results in 165 cases.

A Nikolaou, Z Bourikas, V Maltas

    The Journal of Laryngology and Otology
    |August 1, 1992
    PubMed
    Summary

    Double notch hydroxylapatite partial ossicular replacement prostheses (PORPs) yielded the best hearing outcomes in chronic middle ear disease patients. Incus transposition also showed good results, while polyethylene TORPs had lower success rates.

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    Area of Science:

    • Otolaryngology
    • Biomaterials Science
    • Surgical Outcomes Research

    Background:

    • Chronic middle ear disease often necessitates surgical intervention to restore hearing.
    • Ossiculoplasty, the reconstruction of the middle ear ossicles, is a key procedure.
    • Various prostheses, including incus transposition, polyethylene, and hydroxylapatite materials, are used.

    Purpose of the Study:

    • To compare the hearing success rates of different ossiculoplasty techniques and prostheses.
    • To evaluate the efficacy of incus transposition versus prosthetic reconstruction.
    • To assess the performance of polyethylene and hydroxylapatite prostheses.

    Main Methods:

    • A retrospective review of 165 ossiculoplasty cases performed between 1988-1990.

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  • Categorization of cases by surgical technique: incus transposition, polyethylene prostheses (TORPs/PORPs), and hydroxylapatite prostheses (TORPs/PORPs).
  • Hearing success defined as a post-operative air-bone gap of < 20 dB.

    • Main Results:

    • Hearing success rates: Incus transposition (74%), Polyethylene TORPs (61%), Hydroxylapatite TORPs (65%), Polyethylene PORPs (40%), Double notch Hydroxylapatite PORPs (89%).
    • Double notch hydroxylapatite PORPs demonstrated the highest success rate.
    • No significant statistical difference in hearing improvement among different types of TORPs.

    Conclusions:

    • Double notch hydroxylapatite PORPs are highly effective for ossiculoplasty in chronic middle ear disease.
    • Incus transposition is a viable alternative with good hearing outcomes.
    • Further research into material biocompatibility and complication rates, such as extrusion and infection, is warranted.