Ossiculoplasty with Sculpted Incus: Hearing Results and Risk Factors
Journal of Otorhinolaryngology and Facial Plastic Surgery,
Vol. 2 No. 1 (2016),
5 March 2016
Page pp. 1-6
Background: Incus is the most common damaged ossicle in the ear trauma and chronic infection (COM). Sculpted incus is one of the methods have been used for ossicular reconstruction and transition of sound from tympanic membrane to stapes.
Purpose: To evaluate the success rate and risk factors of ossiculoplasty with sculpted incus.
Methods: A before- after clinical trial study of 25 patients with normal and mobile stapes who underwent ossiculoplasty using autologous or homologous sculpted incus was performed .Pre and post intervention audiometric results were compared. The utility of the middle ear risk index (MERI) in predicting hearing outcome in these cases were evaluated, also outcomes in patients with primary versus staged ossiculoplasty and incus interposition versus incus transposition were compared. P value <0.05 was considered significant.
Results: The mean preoperative air-bone gap (ABG) was 33.9 dB and mean postoperative ABG was 19.4dB, with significant improvement (P value =0.001). The best results achieved in 2000 Hz with 13 dB improvement in mean ABG and worst results in 4000 Hz with 8.8dB improvement. Seventy six percent of patients had postoperative mean ABG less than 20dB and 88% less than 25dB. Hearing results were not significantly different in primary osiculoplasty when compared with staged procedure and in incus interposition osiculoplasty compared with incus transposition. There was no correlation between postoperative ABG and preoperative ABG or the middle ear risk index (MERI)
Conclusion: Osiculoplasty with sculpted incus has a good hearing outcome and recommended in the first stage tympanoplasty. This is independent of middle ear risk factors, if the stapes is normal and mobile.
- Incus interposition
- Incus transposition.
How to Cite
Bayazit Y, Göksu N, Beder L. Functional results of Plastipore prostheses for middle ear ossicular chain reconstruction. The Laryngoscope. 1999; 109(5):709-11.
Janzen V. Ossiculoplasty using a hemi-incus interposition. The Journal of otolaryngology. 1984; 13(4):211-2.
Mawson S. Ossiculoplasty 1966 to 1978. The Journal of Laryngology & Otology. 1979; 93(11):1075-80.
Glasscock ME. Ossicular chain reconstruction. The Laryngoscope. 1976; 86(2):211-21.
Iurato S, Marioni G, Onofri M. Hearing results of ossiculoplasty in Austin-Kartush group a patients. Otology & neurotology. 2001; 22(2):140-4.
Bance M, Morris DP, VanWijhe RG, Kiefte M, Funnell WRJ. Comparison of the mechanical performance of ossiculoplasty using a prosthetic malleus-to-stapes head with a tympanic membrane-to-stapes head assembly in a human cadaveric middle ear model. Otology & Neurotology. 2004; 25(6):903-9.
Merchant SN, McKenna MJ, Mehta RP, Ravicz ME, Rosowski JJ. Middle ear mechanics of Type III tympanoplasty (stapes columella): II. Clinical studies. Otology & neurotology. 2003; 24(2):186-94.
Mehta RP, Ravicz ME, Rosowski JJ, Merchant SN. Middle-ear mechanics of type III tympanoplasty (stapes columella): I. Experimental studies. Otology & neurotology. 2003; 24(2):176-85.
Kartush JM. Ossicular chain reconstruction. Capitulum to malleus. Otolaryngologic Clinics of North America. 1994; 27(4):689-715.
Smith PG, Stroud MH, Goebel JA. Soft-wall reconstruction of the posterior external ear canal wall. Otolaryngology--Head and Neck Surgery. 1986; 94(3):355-9.
Al‐Qudah M, Dawes P. How we do it: modified Wehrs incus ossiculoplasty. Clinical Otolaryngology. 2005; 30(5):461-4.
Brackmann D, Sheehy J, Luxford W. TORPs and PORPs in tympanoplasty: a review of 1042 operations. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery. 1984; 92(1):32-7.
Goldenberg RA. Ossiculoplasty with composite prostheses. PORP and TORP. Otolaryngologic Clinics of North America. 1994; 27(4):727-45.
Ozer E, Bayazit YA, Kanlikama M, Mumbuc S, Ozen Z. Incudostapedial rebridging ossiculoplasty with bone cement. Otology & neurotology. 2002; 23(5):643-6.
Babu S, Seidman MD. Ossicular reconstruction using bone cement. Otology & Neurotology. 2004; 25(2):98-101.
Mokhtarinejad F. Ossiculoplasty with Sculpted Incus: Hearing Results and Risk Factors. Journal of Hearing Sciences and Otolaryngology. 2015; 1(2).
Siddiq M, East D. Long‐term hearing results of incus transposition. Clinical Otolaryngology & Allied Sciences. 2004; 29(2):115-8.
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. Otology & Neurotology. 2005; 26(5):853-8.
Black B. Design and development of a contoured ossicular replacement prosthesis: clinical trials of 125 cases. Otology & Neurotology. 1990; 11(2):85-9.
Gerber MJ, Mason JC, Lambert PR. Hearing results after primary cartilage tympanoplasty. The Laryngoscope. 2000; 110(12):1994-9.
Solmaz M, Yücel E, Ozdemir M, Güldiken Y, Değer K. [Comparison of hearing levels and tympanic membrane healing obtained by cartilage palisade and temporal fascia tympanoplasty techniques: preliminary results]. Kulak burun bogaz ihtisas dergisi: KBB= Journal of ear, nose, and throat. 2001; 9(4):271-4.
Kirazli T, Bilgen C, Midilli RT, and Ögüt Fh. Hearing results after primary cartilage tympanoplasty with island technique. Otolaryngology-Head and Neck Surgery. 2005; 132(6):933-7.
Kazikdas KC, Onal K, Boyraz I, Karabulut E. Palisade cartilage tympanoplasty for management of subtotal perforations: a comparison with the temporalis fascia technique. European archives of oto-rhino-laryngology. 2007; 264(9):985-9.
- Abstract Viewed: 668 times
- PDF Downloaded: 520 times