Ossiculoplasty: A Prospective Study on 50 Patients Using Various Graft Materials

Abstract

With large number of grafts available for ossiculoplasty, choice becomes difficult. An ideal graft should be safe, easily available, cost efficient, with good hearing results, uptake and low extrusion rates. The ear nose and throat surgeon is still facing the indecision over type of graft to be selected. A prospective study was conducted in Department of Otorhinolaryngology, Rajindra Hospital, Patiala (August 2012–2014) on 50 patients 15–60 years, of either sex with ABG > 40 dB. Operative procedure planned and type of graft decided intraoperatively. Autografts included remodelled malleus, remodelled incus and tragal cartilage grafts. Synthetic (Teflon) grafts were PORP and TORP. Graft uptake/failure was noted at 1 and 3 months. PTA done at 3 months postoperatively. Net hearing gain (change in ABG) was calculated for various grafts used and analysed. Mean age was 35.26 ± 13 yrs, male and female 1:1. Most common involved ossicle was incus (100%) followed by stapes (36%) and malleus (34%). Autografts, 23, uptake in 20 (86.95%), failure 3 (13.04%) cases. Synthetic grafts, 27, uptake 18 (66.66%) and failure 9 (33.33%). ‘p’value 0.09 (non significant). Mean hearing gain, autografts 14.47 ± 6.54 dB and synthetic grafts 14.57 ± 13.12 dB. ‘p’ value 0.976 (non significant). No significant difference seen in mean hearing gain and uptake/failure of autografts and synthetic grafts. Autografts being cost effective are preferred choice.

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Abbreviations

ABG:

Air bone gap

AIDS:

Acquired immune deficiency syndrome

COM:

Chronic otitis media

CT:

Computed tomography

dB:

Decibel

HA:

Hydroxyapetite

NS:

Non significant

PORP:

Partial ossicular replacement prosthesis

PTA:

Pure tone audiometry

Sig:

Significance

TORP:

Total ossicular replacement prosthesis

Yrs:

Years

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Correspondence to Ghatdeep K. Lamba.

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Lamba, G.K., Sohal, B.S. & Goyal, J.P. Ossiculoplasty: A Prospective Study on 50 Patients Using Various Graft Materials. Indian J Otolaryngol Head Neck Surg 71, 1140–1146 (2019). https://doi.org/10.1007/s12070-018-01571-0

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Keywords

  • Ossiculoplasty
  • Autografts
  • Synthetic grafts
  • Hearing