Ossiculoplastie par prothèse partielle en titane Spiggle & Theis® dans l’otite cholestéatomateuse : résultats fonctionnels

Objectives

To report the functional results of ossicular reconstruction achieved with a specific partial prosthesis in tympanoplasty for cholesteatoma.

Materials and methods

Forty-four patients presenting cholesteatoma of the middle ear were involved in a retrospective study. Tympanoplasties were performed by the same surgeon over a 30-month period. The patients underwent ossiculoplasty with the shortest nondivisible partial titanium Spiggle & Theis^® prosthesis. Twenty-eight procedures were canal wall-up tympanoplasties and 17 were canal wall-down procedures; 27 were primary tympanoplasties and 18 were revisions. Audiometric data were evaluated before and after surgery, with a mean follow-up of 13.4 months.

Results

Improvement of the air–bone gap was 6 ± 12.2 dB. The overall success rate was 56% and 67% using the Glasgow Benefit Plot and a postoperative air–bone gap lower than 20 dB, respectively. There was no significant functional difference between canal wall-up and canal wall-down procedures. Hearing results were better in primary tympanoplasties than in revisions (p = 0.004). The extrusion rate was 2.2%.

Conclusion

The functional results observed in this study confirm that this partial titanium Spiggle & Theis^® prosthesis is a valuable biomaterial for ossicular reconstruction in primary tympanoplasty for cholesteatoma.