Ossicular reconstruction for incus long-process defects: bone cement or partial ossicular replacement prosthesis.
OBJECTIVE
The objective of this study was to compare hearing results in patients undergoing ossiculoplasty with bone cement (BC) vs partial ossicular replacement prosthesis (PORP) in cases of incudostapedial discontinuity during tympanoplasty surgeries.


METHODS
Case series with chart review.


METHODS
Tertiary referral center.


METHODS
A total of 44 patients with incudostapedial discontinuity, 21 operated on with BC and 23 operated on with PORP, were enrolled in this study.


METHODS
Preoperative and postoperative audiograms at 12 months were evaluated. Pure-tone averages and air-bone gaps (ABGs) were calculated according to the guidelines.


RESULTS
The ABG was 26.61 dB preoperatively and 9.76 dB postoperatively in the BC group. The hearing gain in ABG was statistically significant (P = .0001). The preoperative and postoperative ABGs in the PORP group were 29.48 and 8.89 dB, respectively. The hearing gain in ABG was statistically significant (P = .0001). When the groups were compared for mean gains in the ABG, the difference was not statistically significant (P = .192). The postoperative ABG of less than 20 dB was achieved by 90.4% in the BC group and 86.9% in the PORP group. This difference was not statistically significant (P = .745). No adverse reactions or complications were observed.


CONCLUSIONS
Both BC and PORP are reliable and efficient methods for the repair of incudostapedial joint defects. There is no difference between these 2 methods, based on the hearing results. Additional research is necessary to determine the maximum incudostapedial defect length suitable for bone cement repair.
Department of Otorhinolaryngology, Acibadem Health Care Group, Kozyatagi, Istanbul, Turkey baylancicek@yahoo.com.
Serdar
S
Baylancicek
Department of Otorhinolaryngology, Kocaeli University School of Medicine, Kocaeli, Turkey.
Mete
M
Iseri
Department of Otorhinolaryngology, Kocaeli University School of Medicine, Kocaeli, Turkey.
Deniz Özlem
DÖ
Topdağ
Department of Otorhinolaryngology, Acibadem Health Care Group, Kozyatagi, Istanbul, Turkey.
Emre
E
Ustundag
Department of Otorhinolaryngology, Kocaeli University School of Medicine, Kocaeli, Turkey.
Murat
M
Ozturk
Department of Otorhinolaryngology, Acibadem University School of Medicine, Istanbul, Turkey.
Senol
S
Polat
Department of Otorhinolaryngology, Acibadem Health Care Group, Kozyatagi, Istanbul, Turkey.
Cuneyd
C
Uneri
D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone / Q000379:methods; D001843:Bone Cements / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007188:Incus / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000379:methods; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
D001843:Bone Cements
bone cement; incudostapedial discontinuity; incus; ossiculoplasty; partial ossicular replacement prosthesis