Position of TORP on the Stapes Footplate Assessed With Cone Beam Computed Tomography

Abstract

To improve hearing outcomes of ossiculoplasty with a total ossicular replacement prosthesis (TORP) in ears lacking a footplate superstructure, 3-dimensional computed tomography (3D CT) images were reconstructed to verify the position of the TORP on the footplate and contact between the TORP and the stapes footplate. Retrospective study. University-affiliated tertiary referral center. Six ears of 6 patients who underwent ossiculoplasty with TORP and were followed for greater than 3 years postoperatively. Cone beam CT (CBCT) images. An en face view of the stapes footplate and a volume-rendered 3D image were reconstructed. The en face view of the stapes footplate showed whether the TORP was centered on the stapes footplate. Volume-rendered 3D CBCT images revealed TORP malpositioning or migration, which were not detected on 2-dimensional CBCT images. In such cases, the TORP shaft was in contact with the wall of the oval window niche or the TORP had moved from the stapes footplate. Accurate visualization of TORP location on the footplate is important. Images that accurately show the position of the TORP on the stapes footplate will help improve hearing outcomes.