Incudostapedial Rebridging Ossiculoplasty Using Bone Cement: A Comparative Analysis of Early and Long-term Outcomes.

OBJECTIVE

To evaluate both short-term and long-term hearing outcomes of incudostapedial rebridging ossiculoplasty using glass ionomer bone cement in patients with incus long process defects, and to assess the safety, efficacy, and durability of this technique, given the scarcity of long-term follow-up data in the literature.

STUDY

DESIGN

Retrospective case review.

SETTING

Tertiary referral center at a university hospital.

PATIENTS: A total of 61 patients who underwent incudostapedial bone cement ossiculoplasty between 2010 and 2017. Inclusion criteria were incus long process defects not exceeding two-thirds of its length and complete audiological follow-up data available at all time points.

INTERVENTIONS: Ossicular chain reconstruction with glass ionomer bone cement to bridge the defect between the incus and stapes.

MAIN OUTCOME MEASURES: Air-bone gap (ABG) thresholds measured preoperatively, early postoperatively (6-12 mo), and long-term postoperatively (≥5 y).

RESULTS

The mean preoperative ABG was 31.03 ± 7.10 dB, which significantly improved to 15.95 ± 7.31 dB in the early postoperative period and was maintained at 16.65 ± 7.13 dB in the long term ( P  < 0.001). No significant difference was found between early and late postoperative ABG values. The rate of surgical success, defined as achieving an ABG <20 dB, was 81.9% early postoperatively and 78.7% at long-term follow-up. No major complications, including facial nerve injury or sensorineural hearing loss, were observed.

CONCLUSIONS

Incudostapedial rebridging ossiculoplasty using bone cement is a safe, effective, and durable surgical method for patients with limited incus defects. The functional hearing improvements achieved early postoperatively are largely sustained over long-term follow-up.