Comparison between autologous and artificial graft ossiculoplasty in canal wall down tympanomastoidectomy: A 10 year's personal experience

Background: Ossiculoplasty is the reconstruction of ossicular chain: Malleus, incus, and stapes. This procedure attempts to reestablish the continuity between the tympanic membrane and the oval window. Different materials were used in ossiculoplasty; whether to use autologous grafts or synthetic prosthesis. Aims: This study aimed to evaluate hearing changes in patients' undergone ossiculoplasty as a part of Tympanomastoidectomy. Also, to appraise the autologous reconstruction materials used in ossiculoplasty at Jordan University Hospital (JUH) in comparison to other materials. Materials and Methods: A retrospective study done for a total of 100 patients underwent ossiculoplasty using autologous and artificial graft during canal wall down tympanomastoidectomy at JUH from 2009 to 2019. Results: Overall average mean of air-bone gap (ABG) closure (Hearing Gain) for Group A was 11.07 dB, while for Group B was 7.5 dB; this decrease was found to be highly significant (P = 0.002). In Group A, ABG mean was (34.44 dB) preoperative and reduced to 23.37 dB postoperative, while in Group B was (32.95 dB) preoperative and reduced to 25.45 dB postoperative. Conclusions: Autologous grafts can be used safely in reconstruction of middle ear with favorable outcome. Our study is one of the few reports that compare outcome between artificial and autologous graft in ossiculoplasty.