Short Term Hearing Results of Assembled Allograft Septal CartilageOssiculoplasty of PORP and TORP Configuration / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Various techniques of ossicular reconstruction have been advocated for hearing restoration in the chronic otitis media and cholesteatoma. Although cartilage has good biocompatibility to minimize extrusion or displacement, and is readily available, versatile to use, the hearing results with cartilage graft are poorer than that with plastic materials. The author believed this was due to the sculpturing problem of cartilage, and has devised an assembled type of cartilage ossiculoplasty of PORP and TORP configuration. The technique and short term results are reviewed. METHODS: Of the patients who underwent ossiculoplasty between 1998 and 2000, 103 ears of 95 patients, aged 3-66 years (mean 38.9) were analysed retrospectively. The follow-up period was from 3 to 30 months (mean 9.5). Fifty-one ears were found to be in the second stage and 52 ears were in the first stage. Allograft septal cartilage was sculptured separately and assembled as head and shaft. The average threshold in the frequencies of 500, 1000 and 2000 Hz was used for determination of results. RESULTS: The preoperative mean air-bone gap (ABG) was 42.86+/-8.79 dB and postoperative ABG was 21.22+/-11.33 dB. Gain of ABG was 21.63+/-11.11 dB. Closure of the ABG to within 10 dB, 20dB and 30 dB were achieved in 25.24%, 55.34% and 83.50% respectively. Gain of the ABG did not differ between the one staged and the two staged ossiculoplasty. Patency of eustachian tube orifice and presence of superstructure of stapes did influence the hearing results of this type of ossiculoplasty. CONCLUSION: The assembled type of cartilage ossiculoplasty of PORP and TORP configuration with allograft septal cartilage ossiculoplasty shows satisfactory short term hearing results and represents an excellent alternative to biocompatible prosthesis for ossicular recon-struction.