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Reconstructing the absent lenticular process.

A G Schuring1, W H Lippy, F M Rizer

  • 1Warren Otologic Group, Inc., OH 44484.

The Laryngoscope
|October 1, 1987
PubMed
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Surgeons can reconstruct absent incus lenticular processes using a modified Robinson stapes prosthesis. This technique bypasses the stapes superstructure, yielding successful hearing outcomes in 91% of patients within 20 dB of preoperative levels.

Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Hearing Reconstruction

Background:

  • The absent lenticular process of the incus presents a surgical challenge in middle ear reconstruction.
  • Current methods involve incus repositioning or bridging small gaps, with variable success.

Purpose of the Study:

  • To present a novel solution for reconstructing the absent lenticular process of the incus.
  • To evaluate the hearing outcomes of a modified Robinson stapes prosthesis in such cases.

Main Methods:

  • A Lippy modified Robinson stapes prosthesis was adapted to attach to the stapes footplate and the remaining incus long process.
  • This prosthesis bypasses the stapes superstructure, accommodating an eroded long process.
  • Sixty-three cases were analyzed, with two-thirds undergoing concurrent tympanoplasty.

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Main Results:

  • Hearing results were assessed at 6 months post-surgery.
  • 67% of patients achieved hearing results within 10 dB of preoperative bone conduction levels.
  • 91% of patients achieved hearing results within 20 dB of preoperative bone conduction levels.

Conclusions:

  • The modified Robinson prosthesis offers a stable and effective method for reconstructing the absent lenticular process.
  • This technique provides the most successful hearing results reported to date for this specific condition.