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Year : 2014  |  Volume : 20  |  Issue : 4  |  Page : 173-177

Cortical bone total ossicular replacement prosthesis

1 Department of Otorhinolaryngology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
2 Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Correspondence Address:
Manu Malhotra
3/4, Type IV, All India Institute of Medical Sciences, Rishikesh 249 201, Uttarakhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-7749.146933

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Objectives: Evaluate an autologous cortical bone total ossicular replacement prosthesis (B TORP) made of cortical bone for cost effective and sustainable hearing results. Materials and Methods: A prospective study was undertaken in the patients who underwent tympanoplasty with new B-TORP from January 2011 to December 2011. All patients had an absent superstructure of the stapes and long process of the incus due to chronic otitis media. Totally 40 patients were evaluated. Hearing results were evaluated using four-frequency average pure tone air conduction and air-bone gap (ABG) measured at 0.5, 1, 2, and 3 kHz after a period of 12 months. Pre- and post-operative continuous variables were compared using a paired t-test and data from unequal groups were assessed for significant differences using unpaired t-test. Results: Successful rehabilitation of the ABG to 20 dB or less was achieved in 95% of patients. Overall mean improvement in ABG was 25.8 ± 5.6 dB, which was statistically significant (t = 26.8, P < 0.001). Mean postoperative ABG in the tympanoplasty only group was 12.9 ± 2.7 dB with an average improvement of 26.8 ± 4.9 dB (t = 22.0, P < 0.001) and in the intact canal wall group was 14.9 ± 5.1 dB with an average improvement of 24.5 ± 6.1 dB (t = 16.0, P < 0.001). There was no significant difference between ABG improvements of the two groups (t = 1.2, P > 0.5). Conclusion: The new autologous B-TORP provides sustainable hearing improvement and is bio-compatible, stable, and magnetic resonance imaging compatible.

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