Bone versus cartilage ossiculoplasty: a case series
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20181864Keywords:
Ossiculoplasty, Autologous, Cartilage, Malleus-stapes assemblyAbstract
Background: Ossiculoplasty can be done by using both autologous bone and cartilage. Few literature shows cartilage is better and few shows bone is better. This study has been done to compare the both type of ossiculoplasty and find out the better one by comparing the hearing results.
Methods: Present study is a retrospective study with 6 years data collected from the inpatient’s records. It was conducted in the department of ENT, in a tertiary care hospital of South India. Total number patients studied were 200. Patients with chronic ear disease having ossicular chain defects were evaluated for study. Two types of ossiculoplasty were performed (malleus-stapes assembly and membrane to stapes head interposition) using both cartilage and bone (each 100 patients). Postoperatively hearing result was evaluated at 1month, 6 months and 1 year and statistical analysis was done using z’ test.
Results: Hearing improvement was better with bone ossiculoplasty then cartilage type. Average hearing gain was 33.34dB in bone where as in cartilage it is 29.34 dB. Average improvement in air bone gap is 21dB in bone type, whereas 19dB in cartilage type. But when we applied z’ test, it showed z’ value as 1.4506 indicating insignificant (z’ value should be >1.96).
Conclusions: Study shows that, clinically bone ossiculoplasty is superior to cartilage in terms of hearing improvement. But it is statistically not significant.
References
Frootko NJ. Reconstruction of the middle ear; Scott- Brown’s Otolaryngology; 6th edtn, Butterworth-Heinemann publication, 1997, New Delhi; 3/11/1- 30.
Mills RP. Management of chronic suppurative otitis media; Scott- Brown’s Otolaryngology; 6th ed, Butterworth-Heinemann publication, New Delhi; 1997: 1–11.
Dhingra PL. Cholesteatoma and chronic suppurative otitis media; Disease of ear nose and throat, 3rd edtn, Elsevier publication, Noida; 2004: 87-96.
Kartush JM, Ossicular chain reconstruction, Capitulum to malleus. Otolaryngol Clin North Am 1994;27(4):689-715.
Mahanty S, Maiti A B, Naskar S, Das SK, Mandal S, Karmakar M, A comparative study of outcome of ossiculoplasty using cartilage graft, bone and different alloplasts in chronic otitis media. Indian J Otol. 2015;21(2):144-8.
Dornhoffer JL. Hearing results with the Dornhoffer ossicular replacement prostheses. Laryngoscope 1998;108(4 Pt1):531-6.
Jha S, Mehta K, Prajapati V, Patel D, Kharadi P. A comparative study of ossiculoplasty by sing various graft materials. NJ IRM. 2011;2:53-7.
Amith I, Naragun, RS Mudhol, Harugop AS, Patil PH, Ossiculoplasty with autologous incus versus titanium prosthesis, a comparison of anatomical and functional results. Indian J Otol. 2011;17(2):75-9.
Gardner EK, Jackson CG, Kaylie DM. Results with titanium ossicular reconstruction prosthesis, Laryngoscope. 2004;114:65-70.
Quaranta N, Taliente S, Coppola F, Salonna I. Cartilage ossiculoplasty in cholesteatoma surgery: hearing results and prognostic factors. Acta Otorhinolaryngol Ital. 2015;35(5):338-42.
