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. 2026 Feb 1;47(2):356-363.
doi: 10.1097/MAO.0000000000004735. Epub 2025 Nov 19.

New Semi-Synthetic TORP Ossiculoplasty: Long-Term Results

Giuseppe Malafronte  1 , Antonio Trusio, Valeria Rossetti, Vito Colacurcio, Generoso De Cristofaro, Barbara Filosa
Affiliations

New Semi-Synthetic TORP Ossiculoplasty: Long-Term Results

Giuseppe Malafronte et al. Otol Neurotol. .

Abstract

Objective: To report the long-term hearing outcomes after ossiculoplasty using the new semi-synthetic TORP.

Study design: Prospective study.

Setting: Tertiary referral center.

Methods: From April to May 2023, 18 ossiculoplasties using the new semi-synthetic TORP were performed by the first author. In all patients, the new semi-synthetic TORP was placed between the stapes footplate and the tympanic membrane, both in the presence and absence of the stapes superstructure. The primary outcome was the long-term postoperative air-bone gap (ABG). Hearing stability over time was assessed by comparing short- and long-term postoperative ABG. Secondary outcomes included postoperative air-conduction pure-tone average (ACPTA), word recognition scores, and the percentage of patients achieving ABG ≤20 dB. The extrusion rate was also evaluated.

Results: At short-term follow-up (mean: 8.5 mo), the ABG improved from a mean of 33.5 dB (SD=8.7) to 12.2 dB (SD=5.98); 88.8% of patients (16/18) achieved ABG ≤20 dB. The short-term postoperative ABG was significantly improved compared with preoperative values (t=27.7; P <0.05). At long-term follow-up (mean 24.5 mo), the ABG improved to 13.2 dB (SD=5.49), with 83.3% of patients (15/18) achieving ABG ≤20 dB (t=15.3; P <0.05). No statistically significant difference was observed between short-term and long-term ABG (t=0.45; P > 0.05). The extrusion rate was 0%.

Conclusions: The new semi-synthetic TORP ossiculoplasty demonstrated excellent and stable long-term hearing outcomes with no extrusion.

Keywords: Middle ear prostheses; Ossiculoplasty; PORP; Stapes surgery; TORP; Tympanoplasty.

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Conflict of interest statement

G.M. has patented the shaft prosthesis and he does not have funding to disclose. The remaining authors disclose no conflicts of interest.

Figures

Figure 1
Figure 1
A, Malafronte TORP 5 mm long; (B) Malafronte TORP 6 mm long; (C) Malafronte TORP 7 mm long. Reproduced from Malafronte G. Otol Neurotol 2025;46(5):e152–e156 (CC BY-NC-ND).
Figure 2
Figure 2
Malafronte TORP 6 mm long: (A) synthetic shaft 4 mm long, 0.6 mm in diameter; (A1) synthetic shaft tip 1 mm long, 0.2 mm in diameter; (B) cartilage base 1 mm high, 1 mm in diameter; (B1) perichondrium; (C) cartilage head 1 mm high, 2.5 mm in diameter; (C1) perichondrium; (D) Malafronte TORP assembled; Reproduced from Malafronte G et al., Otol Neurotol 2024; 45:783–789 (CC BY-NC-ND).
Figure 3
Figure 3
A, Malafronte TORP placed between the eardrum and the footplate in presence of the stapes superstructure; (B) Malafronte TORP placed between the eardrum and the footplate in absence of the stapes superstructure. Reproduced from Malafronte G et al., Otol Neurotol 2024;45:783–789 (CC BY-NC-ND).
Figure 4
Figure 4
The preoperative air-conduction pure-tone average and word recognition scores. Reproduced from Malafronte G et al., Otol Neurotol 2024;45:783–789 (CC BY-NC-ND).
Figure 5
Figure 5
The postoperative short-term changes in the air-conduction pure-tone average and word recognition scores.
Figure 6
Figure 6
The postoperative long-term changes in the air-conduction pure-tone average and word recognition scores.
Figure 7
Figure 7
A, Head of the Malafronte TORP; (B) eardrum atelectasis; (C) malleus.
See this image and copyright information in PMC

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