Ossiculoplasty: A Prospective Study on 50 Patients Using Various Graft Materials

Area of Science:

• Otorhinolaryngology
• Surgical Innovation
• Biomaterials in Medicine

Background:

• Ossiculoplasty involves selecting the optimal graft material, a decision often challenging for surgeons.
• Ideal graft characteristics include safety, availability, cost-effectiveness, and favorable hearing outcomes with low extrusion rates.

Purpose of the Study:

• To compare the efficacy of autografts versus synthetic grafts in ossiculoplasty.
• To evaluate graft uptake, hearing gain, and failure rates between different graft types.

Main Methods:

• A prospective study on 50 patients (15-60 years) with air-bone gap (ABG) > 40 dB.
• Intraoperative decision on graft type: autografts (remodelled malleus, incus, tragal cartilage) or synthetic (Teflon PORP, TORP).
• Graft success assessed at 1 and 3 months; pure tone audiometry (PTA) at 3 months to calculate net hearing gain.

Main Results:

• Autografts showed an 86.95% uptake rate, while synthetic grafts had a 66.66% uptake rate (p=0.09, non-significant).
• Mean hearing gain was comparable: 14.47 dB for autografts and 14.57 dB for synthetic grafts (p=0.976, non-significant).
• No statistically significant difference was observed in hearing gain or graft success between autografts and synthetic grafts.

Conclusions:

• Both autografts and synthetic grafts provide similar hearing improvement in ossiculoplasty.
• Autografts are recommended as the preferred choice due to their cost-effectiveness and comparable outcomes.
• Further research could explore long-term outcomes and specific patient factors influencing graft choice.