Utilization of incus with bone cement for total ossicular reconstruction

Abstract

Background: Total ossicular chain reconstructions are performed to connect mobile stapes footplate and tympanic membrane. Data on the use of incus for total ossicular reconstruction is quite limited in the literature.

Objective: The main objective of this study is to describe a novel surgical method that utilizes incus with bone cement to stabilize the ossicular chain for total ossicular reconstruction.

Materials and methods: 16 patients who underwent total ossicular reconstruction using our method were included in this study. We evaluated hearing by comparing preoperative and postoperative air-bone gap (ABG), air conduction (AC) and bone conduction (BC). The percentage of patients achieving ABG ≤20 dB was determined.

Results: The mean preoperative ABG was 35.3 ± 8.2 and postoperative ABG decreased significantly to 23.7 ± 7.6 (p < .001). The mean preoperative AC (57.5 ± 10) decreased significantly postoperatively to (46.5 ± 13.3)(p = .014). There was not any difference between pre- and post-operative BC. We achieved successful hearing results (ABG ≤ 20dB) in 44% of patients.

Conclusion: The use of incus with bone cement stabilization for total ossicular reconstruction seems a feasible option. Good hearing outcomes, and low cost, complication, and extrusion rate may be the main reasons to prefer this method.

背景：进行总听骨链重建以连接移动镫骨足板和鼓膜。在文献资料中, 关于使用砧骨进行总听骨重建的资料非常有限。

目的：本研究的主要目的是描述这样一种新的手术方法, 即利用骨结合剂的砧骨稳定听骨链, 以便进行全听骨重建。

材料和方法：本研究纳入了16例使用我们的方法进行全部听骨重建的患者。我们通过比较术前和术后气骨间隙（ABG）、空气传导（AC）和骨传导（BC）来评估听力。确定达到了ABG ≤ 20dB的患者的百分率。

结果：术前平均ABG为35.3 ± 8.2, 术后ABG显著下降至23.7 ± 7.6（p <.001）。平均术前AC（57.5 ± 10）在术后显著下降至（46.5 ± 13.3）（p = .014）。 BC前后均无差异。我们在44％的患者中取得了成功的听力结果（ABG ≤ 20dB）。

结论：使用骨结合剂稳定的砧骨进行全听骨重建似乎是一种可行的选择。良好的听力结果、低成本、低并发症和低挤压率可能是选用这种方法的主要原因。

Keywords:

• Ossiculoplasty
• total ossicular reconstruction
• incus
• bone cement

Acknowledgment

The authors thank Professor M. Emre Durakoğlugil, M.D. for editorial supervision.

Disclosure statement

The authors report no conflict of interest in this study.