Surgical Outcomes of Malleus Head Interposition Ossiculoplasty During Canal Wall Down Tympano-Mastoidectomy in Cholesteatoma Patients.

Abstract

Objective: To evaluate the hearing outcomes and complications of primary malleus head interposition ossiculoplasty during canal wall down (CWD) tympano-mastoidectomy surgery in patients with cholesteatoma.

Background: Most ossiculoplasty techniques depend on interposition or reposition ossiculoplasty. Therefore, in cases where the Incus is eroded, the malleus becomes the only remaining ossicle and can be used for interposition ossiculoplasty.

Patients and methods: This prospective study included 27 patients with cholesteatoma. All patients received primary malleus head interposition ossiculoplasty during CWD tympano-mastoidectomy. Follow-up of patients carried out in an outpatient clinic through routine follow-up visits at 1, 3, and 6 months using a pure tone audiometer.

Results: Postoperative air bone gab (ABG) closure had values of 11.03, 9.63, 8.96, and 10.7 dB at 500, 1000, 2000, and 4000 Hz, respectively. The mean postoperative ABG decreased from 33.81 ± 5.69 to 24.85 ± 3.08 dB with an improvement of 9 dB that was statistically significant (P < .001).

Conclusions: The malleus head interposition technique is simple and effective for ossiculoplasty in CWD tympano-mastoidectomy. This technique was considered effective in enhancing the stability of the graft and the efficacy of the overall ossiculoplasty procedure. It is characterized by availability, low cost, and low complication rate.