Ossiculoplastie par prothèse partielle en titane Spiggle & Theis ® dans l’otite cholestéatomateuse : résultats fonctionnels

Abstract

Objectives To report the functional results of ossicular reconstruction achieved with a specific partial prosthesis in tympanoplasty for cholesteatoma. Materials and methods Forty-four patients presenting cholesteatoma of the middle ear were involved in a retrospective study. Tympanoplasties were performed by the same surgeon over a 30-month period. The patients underwent ossiculoplasty with the shortest nondivisible partial titanium Spiggle & Theis ® prosthesis. Twenty-eight procedures were canal wall-up tympanoplasties and 17 were canal wall-down procedures; 27 were primary tympanoplasties and 18 were revisions. Audiometric data were evaluated before and after surgery, with a mean follow-up of 13.4 months. Results Improvement of the air–bone gap was 6 ± 12.2 dB. The overall success rate was 56% and 67% using the Glasgow Benefit Plot and a postoperative air–bone gap lower than 20 dB, respectively. There was no significant functional difference between canal wall-up and canal wall-down procedures. Hearing results were better in primary tympanoplasties than in revisions ( p = 0.004). The extrusion rate was 2.2%. Conclusion The functional results observed in this study confirm that this partial titanium Spiggle & Theis ® prosthesis is a valuable biomaterial for ossicular reconstruction in primary tympanoplasty for cholesteatoma.