Hearing Outcomes After Ossiculoplasty With Bone or Titanium Prostheses-A Nationwide Register-Based Study

Area of Science:

• Otolaryngology
• Biomaterials Science
• Surgical Outcomes Research

Background:

• Ossiculoplasty is a surgical procedure to reconstruct the middle ear's ossicular chain.
• Prosthesis materials, including bone and titanium, are used to restore hearing function.
• Comparing the efficacy of different prosthesis materials is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To compare the hearing outcomes of bone versus titanium prostheses in ossiculoplasty.
• To evaluate the performance of partial ossicular replacement prostheses (PORP) and total ossicular replacement prostheses (TORP) based on material.
• To identify potential material-specific advantages in secondary ossicular chain reconstruction.

Main Methods:

• Retrospective, nationwide registry-based study utilizing data from the Swedish Quality Registry for Ear Surgery (SwedEar).
• Inclusion of patients who underwent ossiculoplasty with either bone or titanium prostheses between 2013 and 2019.
• Hearing outcome measured by air-bone gap (ABG) gain.

Main Results:

• No significant difference in ABG or air conduction (AC) outcomes between bone and titanium prostheses for both PORP and TORP.
• PORP demonstrated a slight advantage over TORP in ABG and AC outcomes, regardless of material.
• Titanium prostheses showed a marginal benefit in high-frequency pure tone average for secondary TORP surgeries.

Conclusions:

• Both bone and titanium prostheses yield comparable hearing results in ossiculoplasty for PORP and TORP.
• Titanium may be a preferred material for secondary TORP procedures.
• While success rates (ABG ≤20 dB) are consistent with existing literature, improvements in patient selection and surgical techniques are warranted.