Повышение устойчивости полного протеза слуховых косточек

Abstract

When performing tympanoplasty, one of the key stages is ossiculoplasty – reconstruction of the chain of auditory ossicles through prosthetics. When the chain of auditory ossicles, including the superstructure of the stapes, is destroyed, complete ossicular prostheses are used. The main task of the surgeon when performing ossiculoplasty is to achieve a balance of reliable functional position of the prosthesis ensured by lateral stability, on the one hand, and the exclusion of its contact with surrounding immobile anatomical elements, on the other. According to the literature, the frequency of dislocation of a total prosthesis reaches 13%. The study included 159 patients divided into a study group (72 patients) and a comparison group (87 patients) who underwent ossiculoplasty using a total ossicular prosthesis between 2017 and 2021. In the comparison group, the stability of the prosthesis was ensured by fragments of highly purified gelatin sponge. In the study group, an oval plate of autologous cartilage graft measuring 2,5 and 3,5 mm was additionally used, attached to the prosthetic socket. The results of postoperative observation showed a statistically significant (p < 0,05) reduction in the incidence of prosthesis dislocation to 4,2% compared to the comparison group (10,8%). Functional results were also statistically better when comparing subgroups of patients who underwent tympanoplasty with a first stage using a closed technique.