"Mushroom" Autologous Partial Ossicular Replacement Prosthesis: Long-term Results.

Area of Science:

• Otolaryngology
• Biomaterials Science
• Regenerative Medicine

Background:

• Chronic otitis media frequently leads to incus erosion, necessitating ossicular reconstruction for hearing restoration.
• Traditional ossicular reconstruction methods present challenges in biocompatibility, cost, and long-term efficacy.

Purpose of the Study:

• To evaluate the efficacy and sustainability of a novel autologous mushroom-shaped partial ossicular replacement prosthesis (MPORP) for hearing rehabilitation.
• To assess the cost-effectiveness and bio-integration of the MPORP in patients with chronic otitis media.

Main Methods:

• A prospective study involving 42 patients with chronic otitis media and incus erosion.
• Patients underwent tympanoplasty with MPORP (Group 1) or intact canal wall mastoidectomy with MPORP (Group 2).
• Hearing outcomes were assessed using pure tone audiometry (air conduction, air-bone gap) and word recognition scores at 3, 6, and 12 months postoperatively.

Main Results:

• Successful air-bone gap rehabilitation to 20 dB or less was achieved in 92% of patients.
• Mean improvement in air-bone gap was 23.89 dB (p < 0.001), with a mean postoperative air-bone gap of 15.35 dB.
• Both tympanoplasty and mastoidectomy groups showed statistically significant hearing improvement, with Group 1 demonstrating a trend towards better hearing outcomes.

Conclusions:

• The autologous mushroom-shaped partial ossicular replacement prosthesis (MPORP) is a cost-effective, biocompatible, and effective option for hearing restoration.
• MPORP offers sustainable hearing gain due to potential integration with the stapes head.
• The prosthesis is easily constructed, MRI compatible, and provides a viable alternative for ossicular reconstruction.