title: Neomalleus ossiculoplasty.
abstract: 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.
authors.affiliation: Department of Otolaryngology, Royal Children's Hospital, Brisbane, Australia. bruceblackmd@bigpond.com.au
authors.forename: Bruce
authors.initials: B
authors.lastname: Black
mesh_terms: D001301:Audiometry, Pure-Tone; D004427:Ear Diseases / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008307:Malleus / Q000601:surgery*; D009998:Ossicular Prosthesis; D012189:Retrospective Studies