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Hearing results with the titanium ossicular replacement prostheses
Sébastien Schmerber1, Joelle Troussier, Georges Dumas
1Department of Otorhinolaryngology, University Hospital of Grenoble, 38043, Grenoble Cedex 9, France. SSchmerber@chu-grenoble.fr
Summary
The Kurz titanium partial ossicular replacement prosthesis (PORP) showed better hearing results than the Aerial total ossicular replacement prosthesis (TORP). PORP achieved superior air-bone gap closure, especially in intact canal wall procedures.
Area of Science:
- Otolaryngology
- Audiology
- Biomedical Engineering
Background:
- Ossicular reconstruction is crucial for restoring hearing in patients with conductive hearing loss.
- Various prostheses, including partial ossicular replacement prostheses (PORPs) and total ossicular replacement prostheses (TORPs), are used.
- Evaluating the long-term efficacy of different prostheses is essential for surgical decision-making.
Purpose of the Study:
- To compare hearing outcomes between Kurz titanium Bell partial ossicular replacement prostheses (PORPs) and Aerial total ossicular replacement prostheses (TORPs).
- To identify factors influencing successful ossicular reconstruction.
- To assess the effectiveness of titanium prostheses in ossicular reconstruction.
Main Methods:
- Retrospective chart review of 111 patients undergoing ossiculoplasty with either a PORP or TORP at a tertiary otologic referral center.
- Analysis of audiograms to calculate pre- and post-operative air-bone gaps (ABGs).
- Comparison of ABG closure, prosthesis extrusion rates, and revision surgery rates between PORP and TORP groups.
Main Results:
- Significant improvement in average ABG was observed post-ossiculoplasty.
- The titanium PORP group demonstrated significantly better ABG closure (14.3 dB) compared to the TORP group (25.2 dB).
- Seventy-seven percent of PORP recipients achieved a postoperative ABG of 20 dB or less, versus 52% in the TORP group.
- Factors favoring better outcomes included intact canal wall (ICW) procedures and preserved stapes presence.
Conclusions:
- The Kurz titanium PORP is an effective implant for ossicular reconstruction, yielding superior hearing results compared to the Aerial TORP.
- PORP use in ICW procedures resulted in the best hearing outcomes.
- The titanium Kurz prosthesis has proven effective for ossicular reconstruction at this institution.