[Comparative results of type II ossiculoplasty: incus transposition versus titanium PORP (Kurz)]

The goal of this study was to compare the anatomical and functional results of two groups of patients having an ossiculoplasty type II, either with the incus, or with a PORP Bell Vario prosthesis (Kurz).

Retrospective study concerning 98 patients having had an ossiculoplasty type II with the incus (Incus group) and 50 patients having received a PORP titanium prosthesis Bell Vario from Kurz (Titanium group).

The rate of extrusion was small (1% Incus group and 4% Titanium group). Average preoperative air bone gap of patients who received the Titanium prosthesis was 21.2 dB and 42.8 dB for the incus group. The average postoperative air bone gap was 16.9 dB Titanium group and 25.5 dB Incus group (p < 0.05). The gain was 18.7dB in the Incus group and 4.3 dB in Titanium group (p < 0.05). The difference between pre and post air conduction thresholds in both groups was statistically significant (p < 0.05). The post-op airbone gap was less on 20 dB in 62% of cases (Incus group) and 61% (Titanium group). There was no significant loss of the bone conduction thresholds in each group.

Audiometric results obtained among patients with an incus transposition are better than those obtained with a PORP Titanium prosthesis. These results are to be appreciated by taking account of the greatest proportion of cholesteatoma and of reoperation in the Titanium group. The PORP titanium Bell Vario prosthesis (Kurz) is a material well tolerated by the middle ear as shown by the low rate extrusion. Its qualities (easy and precise measurement, easy positioning) make a material of choice of it when the patient's incus is not usable.