State of the Art: Reconstruction with Synthetic PORP and TORP

  • John DornhofferEmail author
  • David D. Walker
Ossicular Chain Reconstruction (A Rivas and N Manzoor, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Ossicular Chain Reconstruction


Purpose of Review

The purpose of this review article is to present salient pearls of successful ossiculoplasty, with particular attention paid to reconstructive strategies with synthetic partial ossicular prostheses and total ossicular prostheses.

Recent Findings

A refined level of dexterity and an appropriate attention to detail are needed to optimize audiometric outcomes in ossiculoplasty, as is a fundamental understanding of middle ear mechanics and the consistent anatomical relationships that exist in the middle ear, but perhaps the most important determinant of long-term hearing outcomes in ossiculoplasty is the middle ear environment.


Successful ossiculoplasty requires a prudent and thoughtful approach to all phases of the patient’s care, and the final audiometric result is a synergistic product requiring both careful preoperative assessment, thoughtful prosthesis selection, and proficient technical execution.


Ossicular reconstruction Ossiculoplasty Middle ear Ossicular prosthesis PORP TORP 


Compliance With Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Dornhoffer JL. Ossiculoplasty with synthetic PORPS and TORPS. In: Dornhoffer, Gluth, editors. The chronic ear. Stuttgart: Thieme Publishing; 2016.Google Scholar
  2. 2.
    Mehta RP, et al. Determinants of hearing loss in perforations of the tympanic membrane. Otol Neurotol. 2006;27(2):136–43.CrossRefGoogle Scholar
  3. 3.
    Vincent R, Lopez A, Sperling NM. Malleus ankylosis: a clinical, audiometric, histologic, and surgical study of 123 cases. Am J Otolaryngol. 1999;20(6):717–25.Google Scholar
  4. 4.
    Collins WO, Telischi FF, Balkany TJ, Buchman CA. Pediatric tympanoplasty: effect of contralateral ear status on outcomes. Arch Otolaryngol Head Neck Surg. 2003;129(6):646–51.CrossRefGoogle Scholar
  5. 5.
    Coffey CS, Lee FS, Lambert PR. Titanium versus nontitanium prostheses in ossiculoplasty. Laryngoscope. 2008;118(9):1650–8.CrossRefGoogle Scholar
  6. 6.
    Yung MW. Titianium versus nontitanium ossicular prostheses-a randomized controlled study of medium-term outcome. Otol Neurotol. 2010;31(5):752–8.CrossRefGoogle Scholar
  7. 7.
    Huttenbrink K. Middle ear mechanics in research and otosurgery. Dresden, Germany: Department of Oto-Rhino-Laryngology, University Hospital Carl Gustav Carus; 1997.Google Scholar
  8. 8.
    Goode R, Nishihara S. Experimental models of Ossiculoplasty. Otolaryngol Clin N Am. 1994;27(14):663–75.Google Scholar
  9. 9.
    Bance M, et al. 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. Otol Neurotol. 2004;25(6):903–9.CrossRefGoogle Scholar
  10. 10.
    Beutner D, Luers JC, Huttenbrink KB. Cartilage ‘shoe’: a new technique for stabilisation of titanium total ossicular replacement prosthesis at centre of stapes footplate. J Laryngol Otol. 2008;122(7):682–6.CrossRefGoogle Scholar
  11. 11.
    Vincent R, et al. Ossiculoplasty with intact stapes and absent malleus: the silastic banding technique. Otol Neurotol. 2005;26(5):846–52.CrossRefGoogle Scholar
  12. 12.
    Black B. Neomalleus ossiculoplasty. Otol Neurotol. 2002;23(5):636–42.CrossRefGoogle Scholar
  13. 13.
    Blevins NH. Transfacial recess ossicular reconstruction: technique and early results. Otol Neurotol. 2004;25(3):236–41.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology—Head and Neck SurgeryUniversity of Arkansas for Medical SciencesLittle RockUSA

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