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. 2012:2012:346260.
doi: 10.1155/2012/346260. Epub 2012 Aug 16.

Total ossiculoplasty: advantages of two-point stabilization technique

Leonard Berenholz  1 , John Burkey, William Lippy
Affiliations

Total ossiculoplasty: advantages of two-point stabilization technique

Leonard Berenholz et al. Int J Otolaryngol. 2012.

Abstract

Objective. Evaluate a porous polyethylene prosthesis with two-point stabilization in total ossiculoplasty. This approach utilizes a lateral as well as a medial graft to stabilize a total ossicular prosthesis (TOP). Study Design. Retrospective cohort review of total ossiculoplasty. Methods. All patients who underwent total ossiculoplasty during the years 2004-2007 were included in the study group. Only five patients (10%) had primary surgery whereas 45 (90%) underwent revision surgery. Cartilage grafts covering the prosthesis (Sheehy, Xomed) laterally were used in all patients with areolar tissue being used for medial stabilization at the stapes footplate. Follow-up examination and audiometrics were performed a mean of 8.1 months following surgery. Results. The percentage of patients closing their ABG to within 10 dB was 44% with 66% closing their ABG to within 20 dB. The mean four-frequency hearing gain was 15.7 dB. The mean postoperative ABG was 15.7 dB. Conclusion. Audiometric results following total ossiculoplasty surgery using two-point stabilization exceeded results from the otologic literature. Proper two-point fixation with areolar tissue and stabilization utilizing cartilage were the keys to achieving a relatively high percentage of success in chronic ear disease in this sample.

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Figures

Figure 1
Figure 1
Surgical defect with mobile footplate requiring total ossiculoplasty.
Figure 2
Figure 2
Areolar tissue graft placed over footplate and dimpled to receive TOP.
Figure 3
Figure 3
Lateral stabilization achieved with cartilage being placed lateral to TOP and medial to tympanic membrane.
See this image and copyright information in PMC

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