Long-term outcomes of ossiculoplasty techniques.

Abstract

Background: The ideal ossiculoplasty technique should effectively restore sound transmission, be surgically feasible, biocompatible, and stable. Currently, no single material fully meets these criteria in a cost-effective manner.

Objectives: To evaluate and compare the long-term audiological outcomes of various ossiculoplasty techniques.

Materials and methods: This retrospective study included 116 patients (aged 11-72) who underwent ossiculoplasty using cortical bone, bone cement, or titanium prostheses between 2013 and 2019. Preoperative and 2-year postoperative air and bone conduction thresholds (500-4000 Hz), air-bone gap (ABG), and hearing gains were analyzed.

Results: Significant postoperative ABG improvement was observed in the malleus-incus, incus-stapes bone cement, TORP, and PORP groups (p < 0.05). Although hearing gain was noted in the malleus-stapes bone cement and cortical bone groups, the improvement was not statistically significant (p = 0.18 and p = 0.95, respectively). Hearing gain >10 dB was achieved in 76.5% of incus-stapes bone cement and 53% of TORP procedures.

Conclusions and significance: Bone cement offers an effective and economical option for ossiculoplasty, particularly in incudostapedial repairs. Despite no statistically significant difference (p = 0.206), the favorable outcomes of TORP suggest it may be superior to cortical bone in patients with non-functional ossicular chains.