Audiological results of endoscopic surgical repair of the long process of incus

Objective: The purpose of this study is to evaluate our experience with endoscopic repair of ossicular discontinuity at the incudostapedial joint, with or without an intact stapes suprastructure, and present our hearing results. We classify results based on the causative pathology, the type of ossic...

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Autores principales: Badi Aldosari, Jean-Marc Thomassin
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Lenguaje:EN
Publicado: KeAi Communications Co., Ltd. 2017
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spelling oai:doaj.org-article:3a038c940cee43329e544113bde801d42021-12-02T12:05:17ZAudiological results of endoscopic surgical repair of the long process of incus2095-881110.1016/j.wjorl.2017.08.004https://doaj.org/article/3a038c940cee43329e544113bde801d42017-09-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881117300926https://doaj.org/toc/2095-8811Objective: The purpose of this study is to evaluate our experience with endoscopic repair of ossicular discontinuity at the incudostapedial joint, with or without an intact stapes suprastructure, and present our hearing results. We classify results based on the causative pathology, the type of ossiculoplasty, and type of lesion. We demonstrate the ability to endoscopically place a total ossicular replacement prosthesis (TORP), measuring 4.25 mm, between the stapes footplate and the incus remnant to reestablish ossicular continuity. Methods: This was a retrospective case series conducted in tertiary referral center (Hopital de la Timone) Marseille, France. 25 patients underwent incudostapedial rebridging ossiculoplasty between 2009 and 2013. Fifteen cases of chronic otitis media and 10 otosclerosis revisions were included in the study. Three different materials were used in ossiculoplasty, hydroxyapatite cement, incus remnant, and partial/total ossicular replacement prostheses. Audiometric results were evaluated before and after ossiculoplasty. Twelve month follow-up data is provided. Results: The mean postoperative air-bone gap was 15 dB (5–25 dB). Hearing results were better inotosclerosis revisions. Hydroxyapatite cement produced an air-bone gap of 5 dB, TORP placed under the incus produced a 12 dB gap, and TORP placed under the malleus resulted in a 12 dB gap and one deaf ear. In cases of chronic otitis media, the residual air-bone gap was 17 dB with PORP, 12 dB with TORP, and 20 dB with incus transposition. Conclusion: The hydroxyapatite cement is effective in the reconstruction of ossicular discontinuity but the high price limits its utilization. TORP placed under the incus is a reliable and stable method of ossicular reconstruction that is cost effective and offers satisfactory hearing results in selected patients.Badi AldosariJean-Marc ThomassinKeAi Communications Co., Ltd.articleEndoscopic ear surgeryOssiculoplastyIncusOssiculoplasty outcomesOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 3, Iss 3, Pp 148-152 (2017)
institution DOAJ
collection DOAJ
language EN
topic Endoscopic ear surgery
Ossiculoplasty
Incus
Ossiculoplasty outcomes
Otorhinolaryngology
RF1-547
Surgery
RD1-811
spellingShingle Endoscopic ear surgery
Ossiculoplasty
Incus
Ossiculoplasty outcomes
Otorhinolaryngology
RF1-547
Surgery
RD1-811
Badi Aldosari
Jean-Marc Thomassin
Audiological results of endoscopic surgical repair of the long process of incus
description Objective: The purpose of this study is to evaluate our experience with endoscopic repair of ossicular discontinuity at the incudostapedial joint, with or without an intact stapes suprastructure, and present our hearing results. We classify results based on the causative pathology, the type of ossiculoplasty, and type of lesion. We demonstrate the ability to endoscopically place a total ossicular replacement prosthesis (TORP), measuring 4.25 mm, between the stapes footplate and the incus remnant to reestablish ossicular continuity. Methods: This was a retrospective case series conducted in tertiary referral center (Hopital de la Timone) Marseille, France. 25 patients underwent incudostapedial rebridging ossiculoplasty between 2009 and 2013. Fifteen cases of chronic otitis media and 10 otosclerosis revisions were included in the study. Three different materials were used in ossiculoplasty, hydroxyapatite cement, incus remnant, and partial/total ossicular replacement prostheses. Audiometric results were evaluated before and after ossiculoplasty. Twelve month follow-up data is provided. Results: The mean postoperative air-bone gap was 15 dB (5–25 dB). Hearing results were better inotosclerosis revisions. Hydroxyapatite cement produced an air-bone gap of 5 dB, TORP placed under the incus produced a 12 dB gap, and TORP placed under the malleus resulted in a 12 dB gap and one deaf ear. In cases of chronic otitis media, the residual air-bone gap was 17 dB with PORP, 12 dB with TORP, and 20 dB with incus transposition. Conclusion: The hydroxyapatite cement is effective in the reconstruction of ossicular discontinuity but the high price limits its utilization. TORP placed under the incus is a reliable and stable method of ossicular reconstruction that is cost effective and offers satisfactory hearing results in selected patients.
format article
author Badi Aldosari
Jean-Marc Thomassin
author_facet Badi Aldosari
Jean-Marc Thomassin
author_sort Badi Aldosari
title Audiological results of endoscopic surgical repair of the long process of incus
title_short Audiological results of endoscopic surgical repair of the long process of incus
title_full Audiological results of endoscopic surgical repair of the long process of incus
title_fullStr Audiological results of endoscopic surgical repair of the long process of incus
title_full_unstemmed Audiological results of endoscopic surgical repair of the long process of incus
title_sort audiological results of endoscopic surgical repair of the long process of incus
publisher KeAi Communications Co., Ltd.
publishDate 2017
url https://doaj.org/article/3a038c940cee43329e544113bde801d4
work_keys_str_mv AT badialdosari audiologicalresultsofendoscopicsurgicalrepairofthelongprocessofincus
AT jeanmarcthomassin audiologicalresultsofendoscopicsurgicalrepairofthelongprocessofincus
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