Ossicular reconstruction for incus long-process defects: bone cement or partial ossicular replacement prosthesis.

Area of Science:

• Otolaryngology
• Audiology
• Surgical Innovation

Background:

• Incudostapedial discontinuity is a common cause of conductive hearing loss.
• Tympanoplasty aims to restore hearing by reconstructing the ossicular chain.
• Bone cement (BC) and partial ossicular replacement prostheses (PORP) are utilized in ossiculoplasty.

Purpose of the Study:

• To compare hearing results after ossiculoplasty using bone cement (BC) versus partial ossicular replacement prostheses (PORP).
• To evaluate the efficacy of BC and PORP in repairing incudostapedial joint defects during tympanoplasty.

Main Methods:

• A case series with chart review was conducted at a tertiary referral center.
• 44 patients with incudostapedial discontinuity were analyzed (21 BC, 23 PORP).
• Preoperative and 12-month postoperative audiograms were assessed for air-bone gaps (ABGs).

Main Results:

• Both BC and PORP groups showed statistically significant hearing gain (P = .0001).
• Postoperative ABGs were 9.76 dB (BC) and 8.89 dB (PORP), with no significant difference between groups (P = .192).
• Over 86% in both groups achieved a postoperative ABG < 20 dB, with no significant difference (P = .745). No complications were reported.

Conclusions:

• Bone cement (BC) and partial ossicular replacement prostheses (PORP) are reliable for incudostapedial defect repair.
• Hearing outcomes are comparable between BC and PORP for ossiculoplasty.
• Further research is needed to define optimal defect lengths for BC repair.