Comparison of early hearing outcomes of type 2 ossiculoplasty using hydroxyapatite bone cement versus other materials

• Published in: European annals of otorhinolaryngology, head and neck diseases head and neck diseases, 2014-11, Vol.131 (5), p.289-292
• Main Authors: Galy-Bernadoy, C, Akkari, M, Mathiolon, C, Mondain, M, Uziel, A, Venail, F
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Audiometry, Pure-Tone; Bone cement; Bone Cements - therapeutic use; Bone Conduction; Cartilage - transplantation; Child; Chronic Disease; Chronic otitis media; Ear Ossicles - surgery; Female; Follow-Up Studies; Hearing Loss, Conductive - surgery; Humans; Hydroxyapatites - therapeutic use; Male; Middle Aged; Ossicular Prosthesis; Ossicular Replacement; Ossiculoplasty; Otitis Media - surgery; Otolaryngology; Otologic Surgical Procedures; PORP; Prospective Studies; Retrospective Studies; Titanium; Young Adult
• ISSN: 1879-7296; 1879-730X
• DOI: 10.1016/j.anorl.2013.03.009

Abstract Objectives 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. Material and 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 4000 Hz) was compared preoperatively and 3 months postoperatively according to the reconstruction material used. Postoperative results were classified as good (air-bone gap < 10 dB), acceptable (air-bone gap 10–20 dB) or insufficient (air-bone gap > 20 dB) 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 ± 11.52 dB in the cartilage group, 13.31 ± 9.03 dB in the ossicles group, 22.12 ± 11.95 dB in the HAP PORP group, 13.75 ± 11.20 dB in the titanium PORP group, and 7.26 ± 8.99 dB 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. Conclusion 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.