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Related Concept Videos

The Auditory Ossicles01:11

The Auditory Ossicles

1.6K
The auditory ossicles of the middle ear transmit sounds from the air as vibrations to the fluid-filled cochlea. The auditory ossicles consist of two malleus (hammer) bones, two incus (anvil) bones, and two stapes (stirrups), one on each side. These bones develop during the fetal stage and are the ones to ossify first. They are fully mature at birth and do not grow afterward.
The aptly named stapes look very much like a stirrup. The three ossicles are unique to mammals, and each plays a role in...
1.6K

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Related Experiment Video

Updated: Jun 7, 2025

Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
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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.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|November 19, 2024
PubMed
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.

Keywords:
AB GapAustin type C defectsHearing gainMalleusMalleus relocation techniqueOssicular chain reconstructionOssiculoplastyRoleStability

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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.