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Year : 2022  |  Volume : 24  |  Issue : 2  |  Page : 142-148

Ossicular chain reconstruction in austin-kartush type A and B defects using titanium prosthesis: Audiological and anatomical outcomes

1 Department of Otolaryngology, INHS Kalyani, Visakhapatnam, Andhra Pradesh, India
2 Department of Gynaecology, NH Powai, Mumbai, Maharashtra, India
3 Department of Medicine, INS India, New Delhi, India

Correspondence Address:
Surg Cdr (Dr) Deep Kamal
Department of Medicine, INS India, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmms.jmms_163_21

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Introduction: Ossicular chain reconstruction (OCR) augments the hearing mechanism in various ossicular pathologies. Titanium allograft with superior properties was evaluated in the study. Materials and Methods: To assess the audiological and anatomical outcomes following titanium OCR, a retrospective review was performed for 47 cases who underwent OCR from January 2015 to December 2018 at a tertiary care center. The ossiculoplasty was carried out in a single stage tympanoplasty. The partial ossicular replacement prostheses (PORP) and total ossicular replacement prostheses (TORP) were used in 28 and 19 patients, respectively, with a follow up for 12 months. The pre and postoperative air conduction pure tone averages and air bone gaps(ABG) were analyzed. The operative success was defined as a postoperative ABG of ≤20 dB. Fisher's test, analysis of variance (ANOVA), and t test were used depending on data compared. Results: Postoperatively, the mean ABG was 15.4 ± 2.8 dB; about 80. 85% of cases achieved operative success. ABG values showed significant improvement compared with preoperative values (P = 0.001, t test). Successful OCR was achieved 85.7% of PORP and 73.6% TORP cases. Discussion: The mean postoperative ABG was 13.75 ± 5.4 dB for the PORP group and 17.84 ± 2.5 dB for the TORP group. No variation in audiological outcomes was observed when comparing PORPs to TORPs. There was no significant difference in postoperative ABG on comparison of different etiologies (P = 0.508, ANOVA), procedures undertaken (P = 0.226, ANOVA), and primary/ revision surgery (P = 0.172, t test). The extrusion and displacement rates were 2% each. These findings highlight that Titanium OCR gives stable hearing gains with low extrusion rates.

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