Bone cement in ossicular chain reconstruction: systematic review and meta-analysis

Area of Science:

• Otolaryngology
• Biomaterials in Surgery
• Hearing Reconstruction

Background:

• Conductive hearing loss often requires surgical intervention for hearing restoration.
• Ossicular chain reconstruction is a key procedure in managing hearing impairment.
• Various materials are used, including prostheses, autografts, and bone cement.

Purpose of the Study:

• To compare hearing outcomes of ossicular chain reconstruction using bone cement versus alternative materials.
• To evaluate the efficacy of bone cement in chronic otitis media surgery and stapes revision surgery.

Main Methods:

• Systematic review of English-language studies from January 2000 to February 2022.
• Included studies compared hearing outcomes in patients with conductive hearing loss undergoing specific ear surgeries.
• Defined effective hearing outcome as a postoperative air-bone gap (ABG) of ≤20 dB.

Main Results:

• Seven studies involving 360 patients (187 bone cement, 173 non-bone cement) were analyzed.
• Ossiculoplasty with bone cement showed significantly better hearing results.
• The odds ratio for achieving a successful outcome with bone cement was 2.03 (95% CI: 1.16-3.55, p=0.01).

Conclusions:

• Bone cement is more effective than other materials for ossiculoplasty in chronic otitis media and stapes revision surgeries.
• A higher proportion of patients achieved the target air-bone gap (≤20 dB) when using bone cement.
• Bone cement represents a superior option for improving hearing outcomes in specific otologic procedures.