Partial Ossiculoplasty: Malafronte's Double Cartilage Block Versus Incus.

OBJECTIVES

To describe the outcomes of Malafronte's double cartilage block (mDCB) and incus autograft protheses, and to determine which prosthesis gives better and lasting hearing results.

STUDY

DESIGN

Prospective study.

SETTING

ENT Department of AORN "S.G. Moscati" Avellino, Italy MATERIALS AND

METHODS

: Partial columellar ossiculoplasties were performed on 102 patients. Malafronte's DCB was used on 58 patients (group 1). The reshaped autologous incus was used on 44 patients (group 2). The main follow-up for the whole study group was 4.5 years.

MAIN OUTCOME MEASURES: Mean postoperative air-bone gap (ABG) closure to < 20 dB, incidences of prosthesis availability, prosthesis displacement from the tympanic membrane, and prothesis fixation to the middle ear walls.

RESULTS

The hearing results and incidences of prosthesis availability, prosthesis slippage, and prosthesis fixation between groups 1 and 2 were significantly different. At the end of follow-up, a postoperative ABG of 20 dB or less occurred in 87.9% (n = 51) of patients in the group 1 and in 54.5% (n = 24) of patients in group 2. The Malafronte's DCB was always usable. While in 13.7% of cases, the incus was not usable. Prosthesis displacement and prothesis fixation were not observed in group 1. However, they were observed in 15 (34%) and 5 (11.3%) group 2 patients, respectively.

CONCLUSION

The Malafronte's DCB gives more consistent hearing results.

LEVEL OF EVIDENCE: 1b.