Malleus Relocation in Ossicular Reconstruction by Using Autologous Incus

Abstract

Context: Malleus relocation is a technique in ossiculoplasty invented by Robert Vincent to make malleus at the same line of stapes. This study will use this technique with modification by using autologous incus instead of prosthesis for reconstruction. Aims: The objective of this study was to report the method of malleus relocation with auto-incus in ossiculoplasty in cases with chronic suppurative otitis media. Settings and Design: A retrospective study was done at Al-Nahdha Hospital tertiary referral center. Subjects and Methods: This is a study of 12 patients (out of 150 patients who underwent ossiculoplasty surgery done in the department) from 2012 to 2019 for chronic otitis media. This means that all patients had malleus relocation technique with use incus for reconstruction except one patient where malleus relocation done with use of prosthesis instead of incus which was absent. Audiometric assessment included pre- and postoperative audiometric evaluation using conventional audiometry. Air-bone gap, bone-conduction thresholds, and air-conduction thresholds were measured. Statistical Analysis Used: Data were collected and analyzed in SPSS version 21. Confidence interval, mean, and median are used to calculate the pre- and postoperative ABG. Results: Eleven patients underwent malleus relocation with incus interposition. The mean postoperative air-bone gap is 11, and 66.6% of cases had ABG less than or equal to 20 dB. The mean AC postoperative is 21, and 66.7% of cases show improvement of more than 20 dB. Conclusions: Malleus relocation with auto-incus ossiculoplasty showed in this study is safe and gives a good hearing outcome.