Cortical bone total ossicular graft supported with crescent-shaped cartilage.

Abstract

This study aimed to compare the hearing outcomes of patients who underwent different type 4 tympanoplasty techniques. Patients who underwent tympanoplasty for chronic otitis media and were treated with cortical bone total ossicular prosthesis supported with crescent-shaped cartilage (Group 1), cortical bone total ossicular prosthesis (Group 2) and titanium total ossicular prosthesis (Group 3) were included in the study. Hearing outcomes were evaluated and compared with audiological tests performed before and at least 1 year after surgery. There were 12 patients in Group 1 (6 males and 6 females), 14 patients in Group 2 (6 males and 8 females) and 18 patients in Group 3 (10 males and 8 females). After reconstruction, the air conduction threshold changed from 56.83 ± 13.63 to 32.25 ± 13.55dB in Group 1, from 57.43 ± 15.3 to 40.07 ± 18.8dB in Group 2 and from 55.39 ± 15.59 to 42.22 ± 17.32dB in Group 3. Air-bone gap (ABG) changed from 37.58 ± 9.56 to 15.08 ± 9.58dB in Group 1, from 36.71 ± 10.84 to 21.07 ± 11.16dB in Group 2 and from 34.5 ± 11.72 to 22.28 ± 10.13dB in Group 3. Preoperative and postoperative outcomes of all three groups in terms of both air conduction threshold and air-bone gap were significantly different (p < 0.01). Preoperative and postoperative changes in air conduction threshold of the three groups were also significantly different (p = 0.037). However, the differences among the three groups in terms of preoperative and postoperative changes in ABG were not significant (p = 0.057). Cortical bone supported with crescent-shaped cartilage total ossicular prosthesis had better hearing outcomes than other groups.