Autologous total ossicular replacement prosthesis.
OBJECTIVE
To develop an autologous total ossicular replacement prosthesis with sustainable hearing results.


METHODS
The ears of 40 patients, who had chronic otitis media with absent suprastructure of the stapes and long process of the incus, were repaired using the autologous total ossicular replacement technique. Post-operative results were evaluated after 6 and 12 months on the basis of average pure tone air conduction and average air-bone gap measured at 0.5, 1, 2 and 3 kHz.


RESULTS
Successful rehabilitation of pure tone average to 30 dB or less was achieved in 75 per cent of patients, and air-bone gap to 20 dB or less was attained in 82.5 per cent of patients. Overall mean improvement in air-bone gap was 23.9 ± 8.5 dB (p < 0.001). Mean improvements in air-bone gap were significantly greater (p < 0.05) in the tympanoplasty only group (27.3 ± 6.6 dB) and the intact canal wall tympanoplasty group (25.9 ± 6.3 dB) than in the canal wall down tympanoplasty group (16.3 ± 8.9 dB).


CONCLUSIONS
This paper describes an autologous total ossicular replacement prosthesis that is biocompatible, stable, magnetic resonance imaging compatible and, above all, results in sustainable hearing improvement.
Department of Otorhinolaryngology,All India Institute of Medical Sciences,Rishikesh,Uttarakhand,India.
M
M
Malhotra
Department of Otorhinolaryngology,All India Institute of Medical Sciences,Rishikesh,Uttarakhand,India.
S
S
Varshney
Department of Anatomy,All India Institute of Medical Sciences,Rishikesh,Uttarakhand,India.
R
R
Malhotra
D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone / Q000379:methods; D002356:Cartilage / Q000637:transplantation; D005260:Female; D006801:Humans; D007188:Incus / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000295:instrumentation / Q000379:methods*; D010033:Otitis Media / Q000601:surgery*; D013199:Stapes / Q000473:pathology; D014025:Titanium; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods; D055815:Young Adult
D014025:Titanium