"Mushroom" Autologous Partial Ossicular Replacement Prosthesis: Long-term Results.

Abstract

Evaluate a new autologous mushroom-shaped cortical bone partial ossicular replacement prosthesis (MPORP) for cost-effective and sustainable hearing results. Prospective study. Tertiary care center. Forty-two patients suffering from chronic otitis media with intact superstructure of the stapes and partially or completely eroded incus. Group-1 (n = 24) underwent only tympanoplasty with MPORP; group-2 (n = 18) underwent intact canal wall mastoidectomy (ICW) with MPORP. Hearing results were evaluated using a four frequency average (measured at 0.5, 1, 2, 3 kHz) pure tone air conduction (PTA), air-bone gap (ABG), and word recognition scores (WRS) after 3, 6, and 12 months and compared with preoperative results. Overall, successful rehabilitation of ABG to 20 dB or less was achieved in 92% of patients. Mean postoperative ABG was 15.35 ± 4.18 dB showing mean improvement of 23.89 ± 5.95 dB. In group-1, mean postoperative ABG was 18.47 ± 3.65 dB, showing an improvement of 25.92 ± 5.3 dB. In group-2, mean postoperative ABG was 18.47 ± 3.65 dB showing an improvement of 20.14 ± 4.96 dB. Hearing improvement in all the cases together and both the groups checked separately was statistically significant (paired t test, p < 0.001). Group 1 had, on average, 5 dB better hearing than group 2 (unpaired t test, p > 0.05). The MPORP is obtainable from the local site, easily constructed, bio-compatible, cost-effective, less bulky, adequately rigid for sound transmission, magnetic resonance imaging (MRI) compatible, and provides sustainable hearing gain because it has better chances of integration with the head of stapes.