COMPARISON OF HYDROXYAPATITE PORP, HYDROXYAPATITE BONE CEMENT AND AUTOGRAFT INCUS INTERPOSITION METHODS FOR ISOLATED INCUS DEFECT
1Dr. Ersin Arslan Eğitim ve Araştırma Hastanesi, KBB, Gaziantep, Türkiye2Acıbadem Eskişehir Hastanesi, KBB, Eskişehir, Türkiye
3İzmir Katip Celebi Üniversitesi, Atatürk Eğitim ve Araştırması, KBB, İzmir, Türkiye Objective: To compare outcomes hydroxyapatite partial ossicular replacement prosthesis (HA-PORP), hydroxyapatite bone cement (HA-BC), autograft incus interposition (AII) techniques used for the reconstruction of isolated incus defects.
Method: The study was designed retrospectively. The patients were divided into 3 groups according to the ossiculoplasty method used as HA-PORP, HA-BC, and AII. To create more homogenous groups, only patients with MERI score ≤ 2 were included in the study. The sociodemographic characteristics of the patients, preoperative and postoperative audiological findings and the success rates were evaluated and compared between the groups.
Results: HA-PORP group included 26, HA-BC group included 20 and AII group included 28 patients. The mean postoperative audiometry time was 22.7 ± 6.3 months. Overall, the mean preoperative pure tone avearge (PTA) was 46.5 ± 11.6 dB, air bone gap (ABG) was 32.6 ± 9.4 dB, postoperative PTA was 26.7 ± 7.1 dB, ABG was 14.3 ± 6.6 dB, and ABG gain was 14.2 ± 6.4 dB. Postoperative ABG was 20 dB or less in 88.5% of patients in the HA-PORP group, 85% in the HA-BC group, and 85.7% in the AII group. However, there was no statistically significant difference between the groups (p = 0.932). ABG gain was 20.9 + 10.2 dB in the HA-BC group and 14.5 + 10.0 in the AII group. A mean 4.2 ± 1.9 dB more ABG gain was achieved in the BC group when compared to the AII group and the difference was statistically significant. (p = 0.038, CI95%: 0.2 - 8.2 dB).
Conclusion: The HA-BC technique is more advantageous than the AII technique, but generally, all three techniques have similar results. Factors such as middle ear status, surgical experience, and eustachian canal function should be also considered for successful results.
Keywords : Ossicular replacement, Tympanoplasty, PORP, Bone cement, Incus interposition