Audiological Efficiency of Autogenous Bone Columellas

Abstract

Any lesion of the ossicular chain, including total absence, can be restored by an autogenous bone columella which is able to establish permanent contact with the tympanic membrance

A short columella is used for replacing the stapes (group I), another short type for connecting the tympanic membrane with the head of a mobile stapes independently of the presence or absence of the malleus (group II). The whole ossicular chain can be replaced by a long columella connecting the ear drum with the stapes base (footplate) (group III), or with a fascia graft covering the oval window after stapedectomy (group IV)

These simple structures have a good sound-conducting capacity. In our 9-year material of 174 patients with normal or reconstructed tympanic membraces at the time of insertion of the columellas, the figures for the median of improvement in air conduction are 30.0 dB in group I, 23.3 dB in group II, 12.7 dB in group III and 30.0 dB in group IV, which were calculated from the averages of the values obtained at 500, 1 000 and 2 000 Hz. The improvement appears to be permanent

Key Words:

• Reconstruction of ossicular chain
• Autogenous bone columella
• Ossiculoplasty
• Conductive hearing loss
• Surgery for hearing loss