Allograft stapes-incus assembly. Long-term results

Area of Science:

• Otolaryngology
• Surgical Innovation
• Biomaterials in Otology

Background:

• Absence of the stapedial arch, often resulting from radical surgery, presents significant reconstructive challenges in otology.
• Previous treatments, such as using an allograft incus as a columella, have shown variable long-term success.
• The need for durable and effective reconstructive techniques for ossicular chain defects remains critical.

Purpose of the Study:

• To evaluate the long-term efficacy of an allograft stapes-incus assembly in patients with absent stapedial arch and ossicles.
• To compare the outcomes of this novel assembly with the conventional allograft incus columella technique.
• To assess the biocompatibility and resorption rates of the allograft stapes used in the assembly.

Main Methods:

• A cohort of 35 patients with absent stapedial arch, history of radical surgery, and without ossicles underwent reconstruction using an allograft stapes head on the footplate and an allograft incus body.
• Long-term results were analyzed using multiple assessment methods.
• Outcomes were compared to 98 ears treated with an allograft incus columella for a similar pathological condition.

Main Results:

• The allograft stapes-incus assembly demonstrated superior long-term results compared to the allograft incus columella method.
• Significant resorption of the allograft stapes was not observed in the years following surgery.
• The assembly provides a viable alternative reconstructive option for complex ossicular defects.

Conclusions:

• The allograft stapes-incus assembly is a promising alternative to the incudal columella for reconstructing the ossicular chain in specific patient populations.
• This technique offers durable and effective hearing restoration with minimal allograft resorption.
• Further research may explore broader applications of this assembly in otologic surgery.