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In this Egyptian study, the authors looked at the hearing outcomes in patients who underwent ossiculoplasty with cartilage interposition versus those with partial ossicular replacement prosthesis (PORP). They looked at a total of 47 ears from 45 consecutive patients with ossicular discontinuity. Cartilage interposition was used in 27 consecutive patients (Group A) and PORP was used in 20 consecutive patients (Group B). The average preoperative air-bone gap was 32.8 dB in Group A, while the average 12-month postoperative air-bone gap was 8.2 dB. The average preoperative and 12-month postoperative air-bone gap in group B was 29.6 and 9.5 dB, respectively. The difference between the preoperative and postoperative ABG was highly significant in both groups. There was no significant difference noted between both groups in preoperative or postoperative air conduction, bone conduction, or air-bone gap. A postoperative air-bone gap at 12 months within 20 dB was achieved in 80.8% in group A and 76.2% in group B. This difference was not statistically significant. The difference between preoperative and postoperative hearing satisfaction measured by a visual analogue scale was significant in both groups (p< .001). However, the postoperative satisfaction level on the visual analogue scale showed no statistically significant difference between both groups. In terms of complications there were five persistent perforations, evenly spread between Group A and B. The authors acknowledge that they didn’t analyse outcomes with the distance between the incus remnant and stapes head, which might help with the decision making for the type of ossiculoplasty. This study suggests that cartilage interposition and PORP ossiculoplasty are as effective in improving hearing outcomes.

Comparative study between cartilage interposition and partial ossicular replacement prosthesis in ossiculoplasty.
Mahrous AK, Elsamnody AN.
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Sunil Sharma

Great Ormond Street Hospital, UK.

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