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Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique.

Issam Saliba1,2,3, Valérie Sabbah1, Jackie Bibeau Poirier1

  • 1Division of Otorhinolaryngology-Head & Neck Surgery, University of Montreal, Montreal, QC, Canada.

Clinical Medicine Insights. Ear, Nose and Throat
|January 13, 2018
PubMed
Summary

A new fat interposition total ossicular replacement prosthesis (TORP-F) offers improved hearing outcomes compared to the standard TORP-S in both pediatric and adult patients. This technique enhances prosthesis stability, leading to better audiometric results and fewer complications.

Keywords:
PORPTORPconductivehearing lossossicular chainossicular replacementpartialtotal

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Area of Science:

  • Otolaryngology
  • Biomedical Engineering
  • Surgical Innovation

Background:

  • Conductive hearing loss often requires ossicular reconstruction.
  • Standard total ossicular replacement prostheses (TORP-S) have limitations in stability and outcomes.
  • A novel fat interposition technique (TORP-F) was developed to improve prosthesis seating in the oval window niche.

Purpose of the Study:

  • To compare the audiometric results of TORP-F versus TORP-S in pediatric and adult patients.
  • To evaluate complications and undesirable outcomes associated with both TORP techniques.
  • To determine if fat interposition enhances prosthesis stability and hearing restoration.

Main Methods:

  • Retrospective study comparing TORP-F (n=104) and TORP-S (n=54) implants.
  • Fat graft interposition between prosthesis legs for enhanced stability in the oval window niche.
  • Analysis of postoperative air-bone gap, speech discrimination, and prosthesis displacement.

Main Results:

  • TORP-F group achieved a postoperative air-bone gap < 25 dB in 69.2% of patients, versus 41.7% in the TORP-S group.
  • Statistically significant hearing improvements were observed in both pediatric (56.5% vs 40%) and adult (79.3% vs 43.75%) cohorts with TORP-F.
  • Prosthesis displacement occurred significantly less in the TORP-F group (7%) compared to the TORP-S group (19%).

Conclusions:

  • Fat interposition total ossicular replacement prosthesis (TORP-F) demonstrates superior hearing results compared to standard TORP-S.
  • The enhanced stability of TORP-F in the oval window niche contributes to better audiometric outcomes.
  • TORP-F is a promising technique for ossicular reconstruction in both pediatric and adult populations, with reduced risk of displacement.