Partial Ossiculoplasty: Malafronte's Double Cartilage Block Versus Incus

Area of Science:

• Otolaryngology
• Biomaterials in reconstructive surgery
• Audiology

Background:

• Conductive hearing loss often requires ossiculoplasty to restore hearing.
• Autografts and prosthetic materials are used to reconstruct the ossicular chain.
• Comparing the long-term efficacy of different ossiculoplasty techniques is crucial for patient outcomes.

Purpose of the Study:

• To compare the hearing outcomes of Malafronte's double cartilage block (mDCB) prostheses versus reshaped incus autografts.
• To evaluate the durability and complications associated with each prosthesis type in partial columellar ossiculoplasties.

Main Methods:

• A prospective study involving 102 patients undergoing partial columellar ossiculoplasty.
• Group 1 (58 patients) received Malafronte's DCB prostheses.
• Group 2 (44 patients) received reshaped autologous incus grafts, with a mean follow-up of 4.5 years.

Main Results:

• Malafronte's DCB achieved significantly better hearing results, with 87.9% of patients reaching an air-bone gap (ABG) of ≤20 dB, compared to 54.5% with incus autografts.
• The mDCB demonstrated superior availability (100% vs. 86.3%) and had no instances of displacement or fixation issues.
• Incus autografts showed a 13.7% non-usability rate and complications like displacement (34%) and fixation (11.3%).

Conclusions:

• Malafronte's DCB prostheses provide more consistent and reliable hearing restoration compared to incus autografts.
• The mDCB technique is associated with fewer complications and better long-term audiological results in ossiculoplasty.
• This study supports the use of mDCB for improved outcomes in middle ear reconstructive surgery.