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Considerations on Ossicular Reconstruction Using Lenticular Prosthesis for the Necrosed Lenticular Process During Endoscopic Tympanoplasty in Chronic Otitis Media (Mucosal) Cases

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Abstract

Purpose: To evaluate hearing outcome and fate of LPIRP (lenticular process of incus replacement prosthesis) prosthesis in the reconstruction of erosion of long process of the incus. Methods: In this retrospective descriptive study 17 patients with erosion of long process of incus who were operated (reconstructed with LPIRP prosthesis) between January 2015 to December 2017 in a tertiary care center were included. The hearing outcome was evaluated by comparing mean PTA and mean ABG preoperatively and postoperatively at the end of 3 months and 18 months. The graft uptake rate, reperforation, and extrusion of the prosthesis were assessed using otoendoscopy. Results: Preoperative mean PTA was 53.8 dB while mean postoperative PTA was 36.6 dB and 33.4 dB at the end of 3 and 18 months respectively (p-value ˂ 0.05). The mean preoperative ABG was 30.2 dB while the postoperative mean was 13.4 dB and 11.2 dB at the end of 3 months and 18 months respectively (p < 0.05). Extrusion with re-perforation was seen only in one case 1/17 (5.8%). Conclusion: LPIRP has all the characteristics for an ideal middle ear implant which is a cost-effective alternative in the reconstruction of an eroded long process of the incus.

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  1. Department of ENT and Head-Neck surgery Sri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar Dehradun, 248001, Dehradun, Uttarakhand, India

    Arvind Varma & Apoorva Kumar Pandey

  2. Satya Pal Wahi ONGC Hospital Dehradun, Dehradun, Uttarakhand, India

    Chetan Bansal

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  1. Arvind Varma
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  2. Apoorva Kumar Pandey
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  3. Chetan Bansal
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Contributions

Arvind Varma - concept, design, literature search, data acquisition, manuscript preparation, and editing, guarantor. Apoorva Kumar Pandey- assisted in study design, manuscript preparation, and editing, statistical analysis, manuscript review. Chetan Bansal - Data Acquisition and compilation, manuscript preparation, manuscript review. All authors read and approved the final manuscript.

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Correspondence to Apoorva Kumar Pandey.

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Varma, A., Pandey, A.K. & Bansal, C. Considerations on Ossicular Reconstruction Using Lenticular Prosthesis for the Necrosed Lenticular Process During Endoscopic Tympanoplasty in Chronic Otitis Media (Mucosal) Cases. Indian J Otolaryngol Head Neck Surg 75 (Suppl 1), 210–215 (2023). https://doi.org/10.1007/s12070-022-03317-5

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