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Partial Ossiculoplasty: Malafronte's Double Cartilage Block Versus Incus.

Barbara Filosa1, Giorgio Previtero, Generoso Novia

  • 1ENT Department A.O.R.N. "S.G., Moscati," Avellino, Italy.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|February 12, 2019
PubMed
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Malafronte's double cartilage block (mDCB) prostheses offer more consistent hearing results than incus autografts for ossiculoplasty. The mDCB showed superior prosthesis availability and fewer complications, leading to better long-term hearing outcomes.

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.

Related Experiment Videos

  • 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.