Neomalleus ossiculoplasty.
OBJECTIVE
To evaluate the role of ossiculoplasty techniques using neomalleus struts combined with assembly prostheses, in middle ear reconstruction.


METHODS
A retrospective case review of 272 consecutive ossiculoplasty cases in which the malleus was replaced with an autograft strut.


BACKGROUND
Current ossiculoplasty methods have experienced tangible difficulties, including extrusion and displacement (columellae), plus inefficiency and instability (assemblies).


METHODS
Private single-surgeon tertiary referral otologic practice.


METHODS
Ossiculoplasty candidates in whom the malleus was unsuitable for assembly reconstructions because of disease or malpositioning.


METHODS
Ossicular reconstructions using an autograft strut to replace an absent or malpositioned malleus, combined with Spanner assembly prostheses.


METHODS
Pure tone audiology, subdivided into Austin groups, and also progressive pathologic severity groups, using Surgical, Prosthetic, Infection, Tissues, Eustachian (SPITE) indicators.


RESULTS
Two months postoperatively, neomalleus cases returned favorable results in comparison with those of previous techniques, in equivalent situations. The technique appeared to be durable in the longer term.


CONCLUSIONS
Neomalleus techniques offer enhanced success rates when the malleus handle is displaced, diseased, or absent.
Black
Bruce
B
Department of Otolaryngology, Royal Children's Hospital, Brisbane, Australia. bruceblackmd@bigpond.com.au
D001301:Audiometry, Pure-Tone; D004427:Ear Diseases / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008307:Malleus / Q000601:surgery*; D009998:Ossicular Prosthesis; D012189:Retrospective Studies