The effect of using a PORP to reconstruct the ossicular chain under otoendoscopy with and without a malleus handle

Abstract

Background

There are many reports on the role of the malleus handle in ossicular chain reconstruction (OCR). However, the effect of the presence of the malleus handle is not clear.

Aim/objectives

To compare the hearing outcomes of using a partial ossicular replacement prosthesis (PORP) to reconstruct the ossicular chain under otoendoscopy with and without a malleus handle.

Methods

Records of 57 patients requiring OCR were retrospectively analyzed. They were divided into the malleus handle-present group (group 1) and the malleus handle-absent group (group 2). The audiometric results were analyzed pre- and postoperatively. A postoperative air-bone gap (ABG)≤20 dB was considered successful.

Results

The mean improvement in air conduction hearing thresholds was 19.80 dB in group 1 and 16.70 dB in group 2. The mean ABG improvement was 18.09 ± 12.79 dB for group 1 and 17.20 ± 16.44 dB for group 2. The malleus handle-present group achieved higher success (65.63%) than the malleus handle-absent group (52%; p> .05).

Conclusions and significance

Improvements in hearing outcomes were similar for the two groups. However, the malleus handle-present group showed a better reconstruction success rate. Our results suggest that if there is no lesion in the malleus handle, it is recommended to be retained.

Chinese abstract

背景：关于锤骨柄在听骨链重建（OCR）中的作用有许多报道。然而, 锤骨柄的存在的作用尚不清楚。

目的：比较在有或没有锤骨柄的情况下, 使用部分听小骨假体进行耳内镜重建听骨链的听力结果（PORP）。

方法：回顾性分析57例需要OCR的患者的病历。他们分为锤骨柄存在组（组1）和锤骨柄缺失组（组2）。的术前和术后分析听力测定结果。术后气隙（ABG）20 dB被认为是成功的。

结果：第一组的空气传导听力阈值的平均改进为19.80 dB, 第2组为16.70 dB；第1组的平均ABG改进为18.09±12.79 dB, 第2组为17.20±16.44 dB。锤骨柄存在组的成功率(65.63%)高于锤骨柄缺失组（52％； p> .05）。

结论和意义：两组听力结果的改善情况相似。但是, 锤骨柄组表现出更好的重建成功率。根据我们的结果, 如果锤骨柄没有病变, 建议保留。

Keywords:

• PORP
• malleus handle
• ossicular chain reconstruction
• effect

Disclosure statement

The authors declare no conflicts of interest.

Additional information

Funding

This study was supported by Zhejiang Provincial Natural Science Foundation of China [No. LY20H130002] and Wenzhou Science and Technology Bureau [No. Y20180090].