Comparison of Various Graft Materials in the Reconstruction of Ossicular Chain in Patients with Chronic Otitis Media: A Prospective Hospital Based Study

Main Article Content

Niaz Fakhruddin
Chethan Kumar Gangaiah
Gopakumar KP
Geogin George Thottan
Mon Noufal

Abstract

Introduction


Ossicular chain reconstruction is the surgical procedure used to correct the hearing problems in patients with chronic otitis media (COM). In this era, where a large variety of innovative artificial prosthetic materials are being used to replace and reconstruct the ossicular chain, autografts still play a significant role.


Materials and Methods


The present study included 40 patients. Study population was selected based on inclusion and exclusion criteria. The ossicular reconstructive procedure was done under anesthesia and according to the status of the ossicular chain. Temporalis fascia was used to close the perforation. Mainly two procedures were performed: one is intact canal wall and the other is canal wall down. 


Results


Most of the study population was middle aged and males were more compared to females. Thirty five patients had air bone gap above 30dB. In 38 patients, the incus had undergone necrosis. Most of the patients underwent short columella reconstruction. A closure of air bone gap with in 20 dB was achieved in 72.2% in patients with malleus stapes assembly. In short columella 22.2% of patients had closure of air bone gap within 20 dB. Incus remnant grafts gave better hearing gain.


Discussion


The published literature on the result of use of sculptured ossicle and cartilage in tympanoplasty have been reviewed


Conclusion


In the present study, cases with COM showed good hearing results patients implanted with autogenous cartilage and bone.

Article Details

How to Cite
1.
Fakhruddin N, Gangaiah CK, KP G, Thottan GG, Noufal M. Comparison of Various Graft Materials in the Reconstruction of Ossicular Chain in Patients with Chronic Otitis Media: A Prospective Hospital Based Study. BJOHNS [Internet]. 2017Dec.29 [cited 2024Nov.23];25(3):136-41. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/134
Section
Main article
Author Biographies

Niaz Fakhruddin, Sree Mookambika Institute of Medical Sciences, Padanilam, Tamil Nadu

ENT

Assistant Professor 

Chethan Kumar Gangaiah, Sree Mookambika Institute of Medical Sciences, Padanilam, Tamil Nadu

ENT

Associate Professor 

Gopakumar KP, Sree Mookambika Institute of Medical Sciences, Padanilam, Tamil Nadu

ENT

Professor and HOD

Geogin George Thottan, Sree Mookambika Institute of Medical Sciences, Padanilam, Tamil Nadu

ENT

Postgraduate 

Mon Noufal, Sree Mookambika Institute of Medical Sciences, Padanilam, Tamil Nadu

ENT

Postgraduate 

References

Muhammad MB, Muhammad A, Ifra S, Syeda F. Prevalence of cholesteatoma and its complications in patients of chronic suppurative otitis media. JRMC 2011;15(1):16-7

Pinilla M, Garcia BJR, Ramirez C, Bujan J, Jorge HE. Biomaterials in the reconstruction of the human middle ear. JMSMM 1995; 6(12):745-8

Pramila Padmini M, Narasinga Rao B. Morphological variations in human fetal ear ossicles- A study. Int J Anat Res. 2013; 1(2):40-2

Hisham SK, Paul CWT. Canal wall down mastoidectomy: A long term commitment to the outpatients. BMC Ear Nose Throat Disord. 2003; 3:1

Ricardo FB, Anna CDOF. A brief history of mastoidectomy. Int Arch Otorhinolaryngol. 2013; 17(2):168-78

Siva SRP, Srinivasa V, Elangovan S, Jarvis R. Ossicular chain abnormalities in chronic suppurative oitis media and its management. JEMDS 2013; 2(38):7263-6

Shrinivas SC, Prateek VJ, Jeevan NV, Dharmendra KR, Himayat K. Ossiculoplasty: A Prospective study of 80 cases. Iran J Otorhinolaryngol. 2014; 26(76):143-50

Wehrs RF. Homograft ossicles in tympanoplasty. Laryngoscope 1982; 92:540-6

Guildford F. Repositioning of the incus. Laryngoscope 1965; 75:236

Zollner F. Die Schalleitung’s plastiken. Arch Otol. (Stockh) 1955; 45:168

Wehr’s R. Results of homografts in middle ear surgery. Laryngoscope 1978; 88:808-15

Chole RA. Ossicular replacement with self-stabilizing presculptured homologous cartilage. Arch Otolaryngol Head Neck surgery 1982; 108:560-2

Chole RA. Use of presculptured, banked cartilage from plants in ossicular reconstruction. Arch

Otolaryngol. 1987; 113:145-8

Austin DF. Ossicular reconstruction. Otolaryngology clinics of North America 1972; 5:145-60

Black B. Spanner malleus/footplate assembly. Laryngoscope 1994; 104:775-8

Mc Gee, M, Hough J.U.D. Ossiculoplasty. Otolaryngology clinics of North America 1999; 32(3):471-87

Bauer M. Ossiculoplasty: Autogenous bone grafts, 34 years experience. Clinical otolaryngology 2000; 25:257-63

Kartush JM. Ossicular chain recorstruction. Otolaryngology clinics of North America 1999; 27:689-715.