Outcome of hearing in Partial ossicular replacement prosthesis versus cartilage autograft in ossiculoplasty : A comparative study

Chronic otitis media is one of the leading causes of preventable hearing loss in patients in developing countries. Often there is erosion of the ossicles with or without an intact tympanic membrane. Such patients commonly present with moderate to severe hearing loss, with evidence of erosion. In cases where the incus is absent or eroded to a point that it cannot assist in conduction of sound in the middle ear, with an intact stapes suprastructure, the need of an autograft or a prosthesis comes into play. Autografting is commonly done using tragal or conchal cartilages, and prosthesis used are Partial or Total Ossicular Replacement Prosthesis (PORP/TORP).

Long standing and extensivechronic otitis media often causes erosion of the incudostapedial joint with or without an intact malleus, whether it is a squamosal or mucosal disease. The aim of ear surgeries in this case are eradication of the disease and reconstruction of the sound conduction mechanism. Numerous ossiculoplasty techniques have been used to reconstruct the ossicular chain.

Ossiculoplasty material should be ideally biocompatible, stable, safe, affordable and easily available. Autograft, homograft and synthetic prosthesis are widely being used for ossicular reconstruction. In this study conchal cartilage autograft and partial ossicular replacement prosthesis  have been used for ossicular reconstruction. The purpose of this study is to evaluate the experience with ossicular reconstruction for ossicular discontinuity at the incudostapedial joint, with intact stapes suprastructure and malleus, using cartilage autograft and PORP and comparing their hearing results at 1 month, 3 months , 6 months, and 12 months  as well as the failure rates between the two.