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Autologous incus versus titanium partial ossicular replacement prosthesis in reconstruction of Austin type A ossicular defects: a prospective randomised clinical trial

Published online by Cambridge University Press:  21 February 2017

Naragund Amith  and
Mudhol RS
Naragund Amith*
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Nehru Medical College, Belagavi, India
Mudhol RS
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Nehru Medical College, Belagavi, India
*
Address for correspondence: Dr A Naragund, Department of Otorhinolaryngology, Jawaharlal Nehru Medical College, KLE University, Belagavi, Karnataka, India E-mail: amitnargund@rediffmail.com
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Abstract

Objective:

This study aimed to compare the functional and anatomical outcomes of ossiculoplasty using an autograft incus or a titanium partial ossicular replacement prosthesis for reconstructing Austin type A ossicular defects.

Methods:

Patients with Austin A ossicular defects were randomly divided into two groups: one group underwent ossiculoplasty with an autologous incus (the autologous incus group) and the other underwent ossiculoplasty with a titanium partial ossicular replacement prosthesis (the titanium prosthesis group). Otoscopic examination and audiological assessment was done pre-operatively and at 3, 6 and 12 months post-operatively.

Results:

A post-operative average air–bone gap closure of less than 20 dB was seen in 13 patients (65 per cent) in the autologous incus group and 7 (35 per cent) in the titanium prosthesis group. There were fewer post-operative complications in the autologous incus group (20 per cent) than in the titanium prosthesis group (45 per cent).

Conclusion:

Hearing outcomes and graft take up after ossiculoplasty were significantly better when an autologous incus rather than a titanium partial ossicular replacement prosthesis was used to reconstruct Austin type A ossicular defects. The major disadvantages of the titanium prosthesis were unpredictable results and more post-operative complications.

Keywords

IncusOssicular Replacement Prosthesis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 5 , May 2017 , pp. 391 - 398
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented as a poster at the 16th International Otology Course, 26–28 June 2014, Clinique Jean Causse, Beziers, France

References

1 Austin, DF. Ossicular reconstruction. Otolaryngol Clin North Am 1972;1:145–60CrossRefGoogle Scholar
2 Iurato, S, Marioni, G, Onofri, M. Hearing results of ossiculoplasty in Austin-Kartush group A patients. Otol Neurotol 2001;22:140–4CrossRefGoogle ScholarPubMed
3 Yung, M, Smith, P. Titanium versus nontitanium ossicular prosthesis: a randomised controlled study of medium term outcome. Otol Neurotol 2010;1:752–8CrossRefGoogle Scholar
4 O'Reilly, RC, Cass, SP, Hirsch, BE, Kamerer, DB, Bernat, RA, Poznanovic, SP. Ossiculoplasty using incus interposition: hearing results and analysis of the middle ear risk index. Otol Neurotol 2005;1:853–8CrossRefGoogle Scholar
5 Martin, A D, Harner, S G. Ossicular reconstruction with titanium prosthesis. Laryngoscope 2004;1:61–4CrossRefGoogle Scholar
6 Mahadevaiah, A. Ossiculoplasty. In: Surgical techniques in chronic otitis media and otosclerosis: text and atlas, 1st edn. New Delhi: CBS, 2008;92–111 Google Scholar
7 Sanna, M. Ossiculoplasty. In: Haberman, RS, ed. Middle ear and mastoid surgery. New York: Thieme, 2003;176–86Google Scholar
8 Black, B. Reporting results in ossiculoplasty. Otol Neurotol 2003;24:534–42CrossRefGoogle ScholarPubMed
9 Telian, S, Schmalbach, C. Chronic otitis media. In: Snow, JB Jr, Ballenger, JJ, eds. Ballanger's Otorhinolaryngology Head and Neck Surgery, 16th edn. Hamilton: BC Decker, 2003;280–2Google Scholar
10 Iñiquez Cuadra, R, Alobid, I, Bores Domenech, A, Menedez Colino, LM, Caballero, M, Bernal Sprekelsen, M. Type III tympanoplasty with titanium TORP: anatomical and functional results. Otol Neurotol 2010;1:409–14CrossRefGoogle Scholar
11 Ceccato, SB, Maunsell, R, Morata, GC, Portmann, D. Comparative results of type II ossiculoplasty: incus transposition versus titanium PORP (Kurz). Rev Laryngol Otol Rhinol (Bord) 2005;1:175–9Google Scholar
12 Naragund, Amith, Mudhol, RS, Harugop, AS, Patil, PH. Ossiculoplasty with autologous incus versus titanium prosthesis: a comparison of anatomical and functional results. Indian J Otol 2011;1:75–9CrossRefGoogle Scholar
13 Kim, HH, Battista, RA, Kumar, A, Wiet, RJ. Should ossicular reconstruction be staged following tympanomastoidectomy. Laryngoscope 2006;1:47–51 CrossRefGoogle Scholar
14 Yung, M. Long-term results of ossiculoplasty: reasons for surgical failure. Otol Neurotol 2006;1:20–6CrossRefGoogle Scholar
15 Silverstein, H, McDaniel, AB, Lichtenstein, R. A comparison of PORP, TORP, and incus homograft for ossicular reconstruction in chronic ear surgery. Laryngoscope 1986;1:159–65CrossRefGoogle Scholar
16 Geyer, G. Materials for reconstruction of the middle ear. HNO 1999;1:77–91 CrossRefGoogle Scholar
17 Hüttenbrink, KB. Surgical treatment of chronic otitis media III: Middle ear reconstruction. HNO 1994;1:701–18Google Scholar
18 Olgun, L, Kandagon, T, Gultekin, G, Guler, G, Cerci, U. Short term results of ossicular reconstruction with titanium-gold TORP in chronic otitis media surgery. KBB Forum 2005;1:153–6Google Scholar