Perichondrial Roll in Bridging Gap Between Long Process of Incus and Stapes Head in Ossiculoplasty: A New Technique

The erosive effect of chronic otitis media impairs the middle ear's ossicles. Alloplastic materials or autologous incus can be used for ossicular repair. Perichondrial roll is simple to use and saves considerable operative time and cost, especially in developing countries where ossicular prosthesis and bone substitutes are not affordable for the majority of patients.

To evaluate the use of the perichondrial roll in the reconstruction of the long process of the incus.

This study involved 62 patients diagnosed with chronic suppurative otitis media characterized by central perforation, presenting with dry and quiescent ears, and exhibiting an eroded long process of the incus, all of whom underwent tympanoplasty using perichondrial roll and bone pate for reconstruction of the long process of the incus. Audiological evaluations were done for all patients, including preoperative and postoperative evaluation of the air-bone gap and the average pure tone threshold.

The mean air pure tone threshold was 21.6 dB after surgery and 41.7 dB before. The air pure tone thresholds after surgery improved significantly compared with those before ( P <0.01). Before surgery, the air-bone gap was 29.6 dB at 0.5 kHz, 30.5 dB at 1 kHz, and 23.9 dB at 2 kHz. At the completion of 6 months of follow-up, the air-bone gap was 6.9 dB at 0.5 kHz, 7.1 dB at 1 kHz, and 7.3 dB at 2 kHz. The air-bone gap revealed a significant improvement in hearing ( P <0.001).

Perichondrial roll for bridging the gap between the long process of incus and stapes head seems to be a useful and effective method in ossiculoplasty.