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Updated: Jun 5, 2025
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Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
Published on: January 26, 2024
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Cortical bone total ossicular graft supported with crescent-shaped cartilage
Ibrahim Erdim1, Ismail Hologlu2, Alara Izgic2
1Otorhinolaryngology and Head and Neck Surgery Department, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Emek Mahallesi, Namık Kemal Caddesi No:54, 34785, Sancaktepe, Istanbul, Turkey. ibrahim_erdim@hotmail.com.
Summary
Cortical bone prostheses with cartilage showed superior hearing outcomes in tympanoplasty compared to other ossicular reconstruction methods. This study compared hearing results after different tympanoplasty techniques for chronic otitis media.
Area of Science:
- Otolaryngology
- Audiology
- Biomaterials in reconstructive surgery
Background:
- Chronic otitis media (COM) frequently requires surgical intervention to restore hearing function.
- Tympanoplasty with ossicular reconstruction is a common procedure for COM.
- Various prostheses, including cortical bone and titanium, are used for ossicular chain reconstruction.
Purpose of the Study:
- To compare hearing outcomes following different type 4 tympanoplasty techniques.
- To evaluate the efficacy of cortical bone total ossicular prosthesis with and without cartilage support versus titanium total ossicular prosthesis.
Main Methods:
- A comparative study involving patients who underwent tympanoplasty for COM.
- Three groups received different ossicular prostheses: Group 1 (cortical bone with cartilage), Group 2 (cortical bone), and Group 3 (titanium).
- Hearing outcomes were assessed using audiological tests (air conduction threshold and air-bone gap) preoperatively and at least one year postoperatively.
Main Results:
- All three tympanoplasty techniques demonstrated significant improvements in both air conduction threshold and air-bone gap (ABG) post-surgery (p < 0.01).
- Significant differences were observed in the preoperative to postoperative changes in air conduction thresholds among the groups (p = 0.037).
- While Group 1 showed the most favorable changes in air conduction and ABG, the differences in ABG changes among the groups were not statistically significant (p = 0.057).
Conclusions:
- Cortical bone total ossicular prosthesis supported with crescent-shaped cartilage yielded superior hearing outcomes compared to the other tested prostheses.
- This technique may offer an advantage in ossicular reconstruction for type 4 tympanoplasty in COM patients.
- Further research may explore long-term outcomes and patient-specific factors influencing results.
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