A study of outcome of ossiculoplasty using autologous cartilage, refashioned incus, and polytetrafluoroethylene (Teflon) prosthesis in patients of chronic suppurative otitis media

Abstract

Abstract Aim To find out the mean air conduction thresholds (ACT) and air–bone gap (ABG) closure across the treatment groups at the end of 3 and 6 months of follow-up. Material and methods Sixty patients diagnosed with COM with conductive hearing loss were included in the study. Air conduction threshold (ACT) and air–bone gap were calculated and recorded pre-operatively. Surgery was done with clearance of disease followed by reconstruction of hearing in single-stage operation using autologous conchal cartilage, refashioned incus, and polytetrafluoroethylene (Teflon) prosthesis (PORP, TORP) depending upon the intraoperative findings during surgery. Patients were followed for up to 6 months for assessing the hearing outcome in terms of the mean air conduction threshold and mean air–bone gap closure for each group separately. Results The outcome of each ossiculoplasty material was calculated in terms of mean air conduction threshold and mean AB gap closure. Preoperative and postoperative air conduction threshold (ACT) at 3 months and 6 months follow-up of each group was as follows: for the autologous conchal cartilage group, 41.3 (± SD 6.69), 29.2 (± SD 5.39), and 21 (± SD 4.66); for autologous refashioned incus group, 40.4 (± SD 5.43), 28.4 (± SD 6.73), and 20.8 (± SD 4.33); for the Teflon PORP group, 42.9 (± SD 5.68), 31.4 (± SD 6.86), and 34.9 (± SD 6.37); and for the Teflon TORP group, 43.1 (± SD 5.40), 32.5 (± SD 5.91), and 36.2 (± SD 5.31). The mean air–bone gap preoperatively and postoperatively at 3 months and 6 months respectively were as follows: for autologous conchal cartilage, 40.6 (± SD 4.57), 23.7 (± SD 4.48), and 20 (± SD 5.28); for autologous refashioned incus, 39.3(± SD 4.92), 21.9 (± SD 5.61), and 19.4 (± SD 5.82); for Teflon PORP 43.0 (± SD 4.48), 32.8 (± SD 4.84), and 36.3 (± SD 5.56); and for Teflon TORP, 44.5 (± SD 5.56), 33.2 (± SD 5.53), and 35.2 (± SD 5.10). Conclusion The hearing outcome of ossiculoplasty varies with the type of ossiculoplasty material used. Most favorable results were obtained with refashioned autologous incus followed by autologous conchal cartilage. Teflon prosthesis has a significant improvement in hearing outcomes although the results are less favorable.