title: Hearing results with the titanium ossicular replacement prostheses.
abstract: The purpose was to study the hearing results in patients receiving a Kurz titanium Bell partial ossicular replacement prosthesis (PORP) or an Aerial total ossicular replacement prosthesis (TORP). The study was a retrospective chart review in a tertiary otologic referral center. A computerized otologic database was used to identify 111 patients implanted with either a PORP or TORP prosthesis. Audiograms were reviewed and air-bone gaps were calculated for each patient. The improvement of the average air-bone gap (ABG) was 10.2 and 12.7 dB at 3 and 20 months after ossiculoplasty, respectively. Sixty-six percent of patients (73/111) had a postoperative air-bone gap of 20 dB or less. The ABG for the titanium PORP prosthesis was 14.3+/-9.7 dB, compared with 25.2+/-13.7 dB for the TORP prosthesis (P <0.05). The ABG to within 20 dB or less was obtained in the PORP group in 77% of the cases, versus 52% of the cases in the TORP group (P <0.05). Two extrusions of the prostheses were observed at 17 and 20 months after surgery (1.8%). Revision procedures for functional failure were carried out in 20 patients (18%). The rate of sensorineural hearing loss was 3.6%. The major factors influencing good audiometric results were the surgical procedure preserving the external auditory canal and the presence of the stapes. The best hearing results were achieved when a PORP was used in an intact canal wall (ICW) procedure, and the worst hearing results were achieved when a TORP was used in a canal wall down (CWD) procedure. The titanium Kurz prosthesis has been an effective implant at our institution for ossicular reconstruction.
authors.affiliation: Department of Otorhinolaryngology, University Hospital of Grenoble, 38043, Grenoble Cedex 9, France. SSchmerber@chu-grenoble.fr
authors.forename: Sébastien
authors.initials: S
authors.lastname: Schmerber
authors.forename: Joelle
authors.initials: J
authors.lastname: Troussier
authors.forename: Georges
authors.initials: G
authors.lastname: Dumas
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lavieille
authors.forename: Dinh-qui
authors.initials: DQ
authors.lastname: Nguyen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000601:surgery; D002908:Chronic Disease; D005260:Female; D006309:Hearing; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods; D010031:Otitis / Q000601:surgery; D020127:Recovery of Function; D012086:Reoperation; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium