Short-term hearing results using ossicular replacement prostheses of hydroxyapatite versus titanium.

Abstract

The aim of this study was to compare the short-term audiologic results of the ossiculoplasty using partial or total ossicular replacement prostheses (PORP or TORP) made of hydroxyapatite (HA) and titanium (Ti). Fifty-two consecutive patients who underwent ossiculoplasty due to chronic otitis media with or without cholesteatoma were enrolled. Patients were assessed at 6 months postoperatively to establish short-term audiologic results. Preoperative and postoperative air-conduction and bone-conduction thresholds were measured at five frequencies: 0.25, 0.5, 1, 2, and 3 kHz. Postoperative air-bone gap (ABG) of less than 20 dB was considered as successful. Success rates for HA PORP versus Ti PORP and HA TORP versus Ti TORP were compared. Postoperative ABGs at each frequency according to the types of prostheses were also compared. All types of prostheses showed a significant decrease of ABG postoperatively. Regarding PORP, the success rate of postoperative ABG of less than 20 dB was non-significantly higher in Ti group (89%) than in HA group (72%). Regarding TORP, HA group showed non-significantly higher success rate (100%) than Ti group (67%). Comparing postoperative ABGs at each frequency, there was no significant difference in ABGs between HA and Ti groups. There was no difference between the two materials. Both HA and Ti gave good functional results and operator can choose any types of prostheses by personal preference and affordability. Further randomized controlled long-term trials with large sample sizes are needed to establish the difference exactly.