title: Ossiculoplasty in intact stapes and malleus patients: a comparison of PORPs versus TORPs with malleus relocation and Silastic banding techniques.
abstract: OBJECTIVE
  To compare hearing results in patients undergoing ossiculoplasty using either partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP) with Silastic banding and malleus relocation techniques in cases with malleus and stapes both present and mobile.
  
  
  METHODS
  Prospective nonrandomized clinical study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Five hundred eighty-five patients undergoing ossiculoplasty were enrolled in this study from April 1991 to May 2010. Comparative analyses were made between a group of 304 patients who underwent ossiculoplasty with partial prosthesis positioned from the malleus to the stapes head and 281 patients who underwent ossiculoplasty with total prosthesis positioned from the malleus to the stapes footplate. Preoperative and postoperative audiometric evaluation using conventional audiometry, that is, air-bone gap (ABG), bone-conduction thresholds, and air-conduction thresholds were assessed.
  
  
  RESULTS
  In the PORP group, the mean postoperative ABG was 13.1 dB compared with 8.9 dB in the TORP group, (95% confidence interval [CI], 2.2-6.2 dB; p ≤ 0.001). Fifty-four percent of patients from the PORP group had a postoperative ABG of 10 dB or less, compared with 68.9% in the TORP group (mean difference, 14.6%; 95% CI, 6%-23%; p < 0.001). The postoperative ABG was closed to within 20 dB in 70.4% of cases in the PORP group compared with 86.9% in the TORP group (mean difference, 14.5%; 95% CI, 10%-23%; p < 0.001).
  
  
  CONCLUSIONS
  In patients with an absent incus and intact stapes and malleus, ossicular reconstruction with TORP combined with our malleus relocation and Silastic banding technique results in significantly better hearing outcomes compared with reconstructions with PORP.
authors.affiliation: Jean Causse Ear Clinic, Traverse de Béziers, Colombiers, France. robvinc@aol.com
authors.forename: Robert
authors.initials: R
authors.lastname: Vincent
authors.forename: Maroeska
authors.initials: M
authors.lastname: Rovers
authors.forename: Nina
authors.initials: N
authors.lastname: Mistry
authors.forename: John
authors.initials: J
authors.lastname: Oates
authors.forename: Neil
authors.initials: N
authors.lastname: Sperling
authors.forename: Wilko
authors.initials: W
authors.lastname: Grolman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry; D001309:Auditory Threshold; D001844:Bone Conduction; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008307:Malleus / Q000601:surgery*; D008875:Middle Aged; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods*; D011446:Prospective Studies; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome