A Comparative Study of Ossiculoplasty by Using Various Graft Materials

Abstract

Introduction: The use of ossicular graft material in the ossicular chain reconstruction has significantly improved the results in the hearing after the tympanoplasty and tympanomastoid surgery for the chronic otitis media. The ossicular chain transmits the vibration of tympanic membrane to the inner ear with impedance matching function failure to which results in > 50dB hearing loss of conductive variety. Material and Method: A Prospective study of 76 patients who underwent ossiculoplasty was done in the department of ENT & Head and Neck Surgery , Sir T. Hospital ,Bhavnagar, Gujarat between May 2007 to June 2009.Only patients with conductive hearing loss were included in study and underwent ossiculoplasty with using various graft material and assessment done by post operative closure of air bone gap. Most available graft material used are auto graft, cartilage and bone, and various biosynthetic materials like gold,Teflon,plastipore,titanium etc. Results: Majority of patients are middle age group with moderate conductive hearing loss. The comparison of hearing improvement between various graft materials at 2 month and 5 months post operatively were studied in the relation to the postoperative air bone gap closure shows that auto graft and gold prosthesis are cost effective with comparable results obtained as by expensive titanium and plastipore prosthesis. Discussion & Conclusion: The ossiculoplasty materials produce varying results. The titanium and plastipore are rather expensive for the Indian patients , particularly for the government hospital poor class patients. We have tried to evaluate the results using the economical and readily available graft materials like cartilage, bone and gold prosthesis for ossiculoplasty and compared its results with costly plastipore and titanium prosthesis. prosthesis