title: Comparison of early hearing outcomes of type 2 ossiculoplasty using hydroxyapatite bone cement versus other materials.
abstract: OBJECTIVE
  To compare the hearing outcomes of type 2 ossiculoplasties for erosion of the long process of the incus according to the reconstruction material used: cartilage, ossicles, hydroxyapatite (HAP) partial ossiculoplasty reconstruction prostheses (PORP), titanium PORP, and HAP cement. Complications related to cement reconstruction were systematically investigated and reported.
  
  
  METHODS
  Seventy patients operated between 2007 and 2011 for non-cholesteatomatous chronic otitis media were included in this study. Mean air-bone gap (500, 1000, 2000 and 4000Hz) was compared preoperatively and 3 months postoperatively according to the reconstruction material used. Postoperative results were classified as good (air-bone gap<10dB), acceptable (air-bone gap 10-20dB) or insufficient (air-bone gap>20dB) and were compared according to the reconstruction material used.
  
  
  RESULTS
  Groups were comparable in terms of preoperative air-bone gap (P>0.05, Anova). The mean postoperative air-bone gap was 14.82±11.52dB in the cartilage group, 13.31±9.03dB in the ossicles group, 22.12±11.95dB in the HAP PORP group, 13.75±11.20dB in the titanium PORP group, and 7.26±8.99dB in the HAP cement group. Statistical analysis showed a significant air-bone gap difference only between HAP PORP and HAP cement groups (P=0.021, Tukey's test). No significant difference was observed between groups when classified by air-bone gap class (P=0.29, Fisher's test). No major complication was reported with HAP cement with a minimum follow-up of 10 months.
  
  
  CONCLUSIONS
  HAP cement provides similar hearing outcomes to autologous material and titanium PORP, and better outcomes than HAP PORP in our patients. These results must be confirmed in a larger series with a longer follow-up.
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, université Montpellier 1, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Galy-Bernadoy
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, université Montpellier 1, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Akkari
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, université Montpellier 1, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Mathiolon
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, université Montpellier 1, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France; Unité Inserm U1051, institut des neurosciences de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Mondain
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, université Montpellier 1, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France; Unité Inserm U1051, institut des neurosciences de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Uziel
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, université Montpellier 1, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France; Unité Inserm U1051, institut des neurosciences de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France. Electronic address: f-venail@chu-montpellier.fr.
authors.forename: F
authors.initials: F
authors.lastname: Venail
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001843:Bone Cements / Q000627:therapeutic use*; D001844:Bone Conduction; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D002908:Chronic Disease; D004429:Ear Ossicles / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000601:surgery; D006801:Humans; D006882:Hydroxyapatites / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement; D010033:Otitis Media / Q000601:surgery; D013506:Otologic Surgical Procedures; D011446:Prospective Studies; D012189:Retrospective Studies; D014025:Titanium; D055815:Young Adult
chemical_list: D001843:Bone Cements; D006882:Hydroxyapatites; C475044:hydroxyapatite cement; D014025:Titanium
keywords: Bone cement; Chronic otitis media; Ossiculoplasty; PORP