Malleus to Stapes Bone Cement Rebridging Ossiculoplasty: Why Don't We Perform Frequently?

Ann Otol Rhinol Laryngol. 2016 Jun;125(6):445-51. doi: 10.1177/0003489415618678. Epub 2015 Dec 1.

Abstract

Objective: To evaluate the effectiveness of malleus to stapes bone cement rebridging (MS-BCR) for Austin Kartush group A ossicular defects and compare the audiological results with incus interposition (IP) and incus to stapes bone cement rebridging (IS-BCR).

Methods: Patients for whom type 2 tympanoplasty had been performed in a tertiary referral center were examined. Revision cases and those with graft failure were excluded. Three treatment groups were IS-BCR, IP, and MS-BCR. Preoperative and postoperative audiological results were compared.

Results: A total of 92 patients were enrolled. The IS-BCR was performed in 42 (45.65%), IP in 18 (19.56%), and MS-BCR in 32 (34.78%) patients. Postoperative mean air bone gap was 20.1 ± 9.8 dB HL and did not differ significantly between the groups (P = .271). Postoperative mean air bone gap less than 20 dB HL was achieved in 23 (54.7%) patients in IS-BCR, 10 (55.5%) patients in IP group, and 24 (75%) patients in MS-BCR group (P = .06). Mean closure in air bone gap was 14.0 ± 11.6 dB HL. The changes in mean and frequency-specific air bone gap were not significantly different between treatment groups (P > .05).

Conclusion: Malleus to stapes bone cement rebridging may provide hearing results comparable to IS-BCR and IP.

Keywords: chronic middle ear disease; chronic otitis media; functional measures; middle ear; ossiculoplasty.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Audiometry, Pure-Tone
  • Bone Cements / therapeutic use*
  • Child
  • Cholesteatoma, Middle Ear / complications
  • Cholesteatoma, Middle Ear / surgery*
  • Chronic Disease
  • Female
  • Hearing Loss, Conductive / etiology
  • Hearing Loss, Conductive / surgery*
  • Humans
  • Incus / surgery*
  • Male
  • Malleus / surgery*
  • Mastoid / surgery
  • Middle Aged
  • Ossicular Replacement / methods
  • Otitis Media / complications
  • Otitis Media / surgery*
  • Retrospective Studies
  • Stapes
  • Stapes Surgery / methods
  • Treatment Outcome
  • Tympanoplasty / methods*
  • Young Adult

Substances

  • Bone Cements