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Bone Cement Reconstruction of the Ossicular Chain: A Preliminary Report
Author(s) -
Feghali Joseph G.,
Barrs David M.,
Beatty Charles W.,
Chen Douglas A.,
Green J. Douglas,
Krueger Wesley W. O.,
Shelton Clough,
Slattery William H.,
Thedinger Bradley S.,
Wilson David F.,
McElveen John T.
Publication year - 1998
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199806000-00010
Subject(s) - incus , footplate , stapes , medicine , audiogram , prosthesis , malleus , dentistry , surgery , orthodontics , audiology , hearing loss , middle ear , mechanical engineering , engineering
Objective: To determine the feasibility and efficacy of using a bone cement, Oto‐Cem, to reconstruct the ossicular chain. Study Design: Prospective clinical trial on nine consecutively chosen adult patients with ossicular chain defects. Patients and Setting: Nine patients with ossicular chain defects involving the long process of the incus were treated at the Carolina Ear and Hearing Clinic. The ossicular chain was reconstructed using bone cement by itself or in conjunction with a stapes prosthesis. Main Outcome Measures: Preoperative audiograms were compared with audiograms 3, 6, and 12 months after reconstruction. Results: There was a mean pure‐tone average (PTA) improvement of 15 dB in patients undergoing incus to stapes suprastructure reconstruction with the bone cement. The incus to mobile footplate reconstruction (using a stapes prosthesis attached to the newly reconstructed incus) resulted in a 34‐dB PTA postoperative improvement. Two of the three patients with incus to oval window repairs experienced a 10‐dB improvement in PTA. One of the three patients experienced a loss in speech discrimination and a 2‐dB loss in PTA. Conclusions: Despite the limited number of patients, this preliminary study demonstrates the effectiveness of Oto‐Cem in reconstructing a foreshortened incus. There was a substantial hearing improvement in all but one patient in the incus to stapes or the incus to footplate categories.