Comparison of early hearing outcomes of type 2 ossiculoplasty using hydroxyapatite bone cement versus other materials.

OBJECTIVES: To compare the hearing outcomes of type 2 ossiculoplasties for erosion of the long process of the incus according to the reconstruction material used: cartilage, ossicles, hydroxyapatite (HAP) partial ossiculoplasty reconstruction prostheses (PORP), titanium PORP, and HAP cement. Complications related to cement reconstruction were systematically investigated and reported.

MATERIAL AND METHODS: Seventy patients operated between 2007 and 2011 for non-cholesteatomatous chronic otitis media were included in this study. Mean air-bone gap (500, 1000, 2000 and 4000Hz) was compared preoperatively and 3 months postoperatively according to the reconstruction material used. Postoperative results were classified as good (air-bone gap<10dB), acceptable (air-bone gap 10-20dB) or insufficient (air-bone gap>20dB) and were compared according to the reconstruction material used.

RESULTS: Groups were comparable in terms of preoperative air-bone gap (P>0.05, Anova). The mean postoperative air-bone gap was 14.82±11.52dB in the cartilage group, 13.31±9.03dB in the ossicles group, 22.12±11.95dB in the HAP PORP group, 13.75±11.20dB in the titanium PORP group, and 7.26±8.99dB in the HAP cement group. Statistical analysis showed a significant air-bone gap difference only between HAP PORP and HAP cement groups (P=0.021, Tukey's test). No significant difference was observed between groups when classified by air-bone gap class (P=0.29, Fisher's test). No major complication was reported with HAP cement with a minimum follow-up of 10 months.

CONCLUSION: HAP cement provides similar hearing outcomes to autologous material and titanium PORP, and better outcomes than HAP PORP in our patients. These results must be confirmed in a larger series with a longer follow-up.