Comparison of partial vs. total ossicular chain reconstruction using titanium prosthesis: a retrospective cohort...

Area of Science:

• Otolaryngology
• Biomedical Engineering
• Surgical Innovation

Background:

• Ossicular chain reconstruction is crucial for restoring hearing in patients with conductive hearing loss.
• Titanium prostheses, including partial ossicular replacement prosthesis (PORP) and total ossicular replacement prosthesis (TORP), are commonly used.
• Evaluating the comparative efficacy of different prosthesis types is essential for surgical decision-making.

Purpose of the Study:

• To compare the hearing outcomes of titanium PORP versus titanium TORP with a footplate shoe (Omega Connector) in second-stage ossicular chain reconstruction.
• To assess the effectiveness of these prostheses in improving audiological parameters post-surgery.

Main Methods:

• A retrospective cohort study involving 248 patients undergoing second-stage ossicular chain reconstruction between August 2017 and June 2021.
• Comparison of hearing outcomes between patients who received PORP (n=115) and TORP (n=133).
• Assessment of pre- and post-operative audiometric data, including bone conduction (BC), air conduction (AC), air-bone gap (ABG), speech reception threshold (SRT), and speech discrimination score (SDS).

Main Results:

• No statistically significant differences were observed between the PORP and TORP groups in terms of gains in BC, AC, ABG, SRT, and SDS.
• Analysis of ABG gains showed no significant differences between the two groups, even when analyzing frequency-specific data for low and high frequencies in ears with pre-operative conductive hearing loss.

Conclusions:

• Titanium TORP with a footplate shoe (Omega Connector) demonstrates comparable hearing outcomes to titanium PORP in staged ossiculoplasty.
• This study adds evidence supporting the interchangeability of PORP and TORP in second-stage ossicular chain reconstruction, offering valuable insights for clinical practice.