Abstract
BackgroundMiddle ear ossiculoplasty refers to the reconstruction of the middle ear ossicular chain when there is an in continuity or fixation of the ossicular chain due to disease process or trauma. Various materials and techniques have been used to regain the function and continuity of the ossicular chain. But the ideal reconstruction materials and techniques are yet to be developed. The first ossiculoplasty was reported in modern medical literature by Matte in 1901. (1) Since then, various people have used different materials and techniques for ossiculoplasty(2).In a Sri Lankan setting, only a few centres of the country perform ossiculoplasty though almost all the Ear nose throat departments in the country perform myringoplasty for CSOM (Chronic suppurative otitis media). The main purpose of myringoplasty is to make the ear safe from recurrent ear infection. Improving hearing is not the main aim for myringoplasty in Sri Lanka though some patients get the hearing benefit.Material and methodGray’s total ossicular replacement prosthesis (TORP )and partial ossicular replacement prosthesis (PORP) were used. Retrospective data analysis was carried out from patients who underwent surgery from 1st of July 2017 for three-year periods and calculated the success rate using the improvement of hearing in postoperative audiograms.Conclusion and recommendationsOur experience in ossiculoplasty with TORP and PORP showed a reasonable success rate on hearing for traumatic or infective conductive hearing loss. We recommend carrying out it routinely with myringoplasty in the case of damage ossicular chain in the middle ear. We also recommend the ministry of health to make available other types of ossicular prostheses like angular clip prosthesis and malleus replacement prosthesis in addition to TORP and PORP.
Highlights
Middle ear ossiculoplasty refers to the reconstruction of the middle ear ossicular chain following disruption of the ossicular chain due to trauma or disease process
All the patients underwent ossiculoplasty during the study period 01/07/2017 to 30/06/2020 by the author were included in the study
Titanium total ossicular replacement prosthesis (TORP) and partial ossicular replacement prosthesis (PORP) were the commonest used ossicular prosthesis. fluoroplastic pistons were used to repair the gap between fractured stapes
Summary
Middle ear ossiculoplasty refers to the reconstruction of the middle ear ossicular chain following disruption of the ossicular chain due to trauma or disease process. In 1951 – Wullstein, A German Otologist used Vinyl Acryllic to fill the gap of the Ossicular chain [2] Hall and Ryztner in 1957 reported a series of cases of ossiculoplasty using autograft ossicles. They used the incus to fill the gap between malleus and stapes. For both allograft and homograft ossicular repair, it was essential to maintain a tissue bank To overcome this people all over the world tried various synthetic and non-organic materials for ossicular chain reconstruction, the earliest material was gold prosthesis and In the late1960s and early 1970s gold prosthesis gave reasonably good results[11]. Improving hearing is not the main aim for myringoplasty in Sri Lanka though some patients get the hearing benefit
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