Related Experiment Video
Updated: Jun 7, 2025
09:07
Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
Published on: January 26, 2024
2.2K
Ossicular Reconstruction with TORP: Does Malleus has a Role?
Bhanu Bhardwaj1, Arvinder Singh Sood2, Jaskaran Singh3
1Sri Guru Ram Das University of Health Sciences, 27-C Sant Avenue, The Mall, Amritsar, Punjab 143001 India.
Summary
Preserving the malleus in ossiculoplasty may improve implant stability, but does not significantly enhance hearing outcomes or reduce air-bone gap compared to its removal. Further research is needed.
Area of Science:
- Otolaryngology
- Biomedical Engineering
- Audiology
Background:
- The malleus plays a role in sound transmission via a catenary lever mechanism.
- Its function in ossiculoplasty with prostheses remains debated, despite preventing graft lateralization.
Purpose of the Study:
- To compare hearing outcomes and implant stability in ossiculoplasty with and without malleus preservation.
Main Methods:
- A prospective longitudinal study randomized 60 patients undergoing TORP reconstruction into two groups: malleus preserved (M+) and malleus removed (M-).
- Outcomes assessed included hearing improvement, air-bone (AB) gap reduction, and implant stability.
Main Results:
- Both groups showed significant hearing improvement, with no statistically significant difference in hearing gain or AB gap reduction between M+ and M- groups.
- Implant extrusion occurred in 1 case (M+) versus 6 cases (M-), a statistically significant difference.
- The M+ group showed better implant stability, suggesting a role for the malleus in long-term outcomes.
Conclusions:
- Preserving the malleus in ossiculoplasty does not significantly improve hearing or reduce the air-bone gap.
- Malleus preservation is associated with improved implant stability and reduced extrusion rates.
- The malleus may play a significant role in the long-term stability of ossiculoplasty implants.
