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The use of bone cement for ossicular chain defects
M Tayyar Kalcioglu1, Mehmet Tan, Jelle Fleerakkers
1Department of Otolaryngology, Istanbul Medeniyet University Medical Faculty, Istanbul, Turkey, mtkalcioglu@hotmail.com.
Summary
Bone cement effectively reconstructs ossicular chain defects, significantly improving hearing outcomes. This cost-effective material aids in procedures like incudostapedial re-bridging and interposition, offering a viable surgical solution.
Area of Science:
- Otolaryngology
- Audiology
- Biomaterials
Background:
- Ossicular chain defects can result from trauma or chronic otitis media, leading to conductive hearing loss.
- Traditional reconstruction methods may be complex or costly.
- Bone cement presents a potentially simpler and more economical alternative for ossicular reconstruction.
Purpose of the Study:
- To evaluate the audiologic outcomes of ossicular chain reconstruction using bone cement.
- To assess the efficacy of bone cement in different types of ossicular defects.
Main Methods:
- A retrospective study analyzing 120 patients with ossicular chain defects.
- Three groups were defined based on the type of reconstruction: ossiculoplasty, incus interposition, and total ossicular replacement with reshaped incus.
- Bone cement was used as a fixator in all groups. Preoperative and postoperative pure-tone audiometry were compared.
Main Results:
- Significant hearing improvement was observed across all three groups (p < 0.001).
- Mean air-bone gaps improved from 34.8 to 15.6 dB (Group 1), 35 to 18.4 dB (Group 2), and 43.4 to 19.8 dB (Group 3).
- Postoperative air-bone gaps ≤20 dB were achieved in 76% (Group 1), 64% (Group 2), and 46% (Group 3) of patients.
Conclusions:
- Bone cement is an effective and economical option for specific ossicular chain reconstructions, including incudostapedial re-bridging.
- It serves as a reliable fixator for interposed incus and reshaped incus prostheses, preventing displacement.
- Bone cement offers a valuable solution for improving hearing in patients with various ossicular defects.
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