Hearing results using titanium ossicular replacement prosthesis in intact canal wall tympanoplasty for cholesteatoma

Abstract

Conclusions: Titanium proved to be a valuable alternative to ossicles in ossiculoplasty procedures. Complication rates are comparable to those obtained by other authors with titanium and nontitanium prostheses. Hearing results were worse compared with other reports; however, no conclusion can be drawn on the basis of the literature because of the heterogeneity of the populations studied. Objectives: To evaluate the results and complications of total (TORP) and partial (PORP) titanium ossicular replacement prostheses in middle ear cholesteatoma. Methods: Fifty-seven patients affected by acquired cholesteatoma of the middle ear undergoing titanium ossiculoplasty during second stage intact canal wall tympanoplasty were evaluated. Postoperative hearing gain, complication rate, and revision rate were analyzed. Results: Average postoperative gain was 13.6 dB HL for PORP and 17.9 dB HL for TORP. After ossicular reconstruction the mean postoperative ABG was 24.1 dB HL in PORPs and 27.2 dB HL in TORPs. The difference in air-bone gap (ABG) between the two groups after ossiculoplasty was not significant. The number of patients with an ABG > 30 dB was higher in the TORP group compared with the PORP group (p = 0.024) after ossicular reconstruction. The total extrusion rate was 5.2% and the total revision rate was 10.5%.