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Management of incus long process defects: incus interposition versus incudostapedial rebridging with bone cement

Published online by Cambridge University Press:  23 August 2013

F Celenk ,
T Baglam ,
E Baysal ,
C Durucu ,
Z A Karatas ,
S Mumbuc  and
M Kanlikama
F Celenk*
Affiliation:
Department of Otorhinolaryngology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
T Baglam
Affiliation:
Department of Otorhinolaryngology, Marmara University Faculty of Medicine, Istanbul, Turkey
E Baysal
Affiliation:
Department of Otorhinolaryngology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
C Durucu
Affiliation:
Department of Otorhinolaryngology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
Z A Karatas
Affiliation:
Department of Otorhinolaryngology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
S Mumbuc
Affiliation:
Department of Otorhinolaryngology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
M Kanlikama
Affiliation:
Department of Otorhinolaryngology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
*
Address for correspondence: Dr Fatih Celenk, Department of Otorhinolaryngology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey E-mail: facelenk@yahoo.com
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Abstract

Objective:

This study aimed to compare the hearing results of incus interposition and bone cement ossiculoplasty in patients with incus long process defects.

Materials and methods:

Ninety-nine patients with incus long process defects were included. Incus interposition was performed in 49 patients (group 1) and bone cement ossiculoplasty was performed in 50 patients (group 2). Group 1 included 29 female and 20 male patients, with a mean age ± standard deviation of 29.43 ± 12.5 years (range, 8–58 years). Group 2 comprised 32 female and 18 male patients, with a mean age ± standard deviation of 29.1 ± 14.89 years (range, 8–67 years).

Results:

The mean hearing gain ± standard deviation was 15.2 ± 9.01 dB in group 1 and 19.36 ± 9.08 dB in group 2. Hearing gain was significantly greater in the bone cement group than in the incus interposition group (p = 0.0186). Successful hearing results (i.e. air–bone gap < 20 dB) were achieved by 63.2 per cent of group 1 patients and 78 per cent of group 2 patients.

Conclusion:

Incus interposition and bone cement ossiculoplasty are safe and reliable methods with which to manage incus long process defects. Bone cement ossiculoplasty gives a greater hearing gain in appropriate cases.

Keywords

IncusBone CementsOssicular Replacement

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 9 , September 2013 , pp. 842 - 847
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1Somers, T, Van Rompaey, V, Claes, G, Salembier, L, van Dinther, J, Andrzej, Z et al. Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling: how to manage incudostapedial discontinuity. Eur Arch Otorhinolaryngol 2012;269:1095–101Google Scholar
2McGee, M, Hough, JV. Ossiculoplasty. Otolaryngol Clin North Am 1999;32:471–88Google Scholar
3Ráth, G, Bauer, M, Pytel, J, Vóna, I, Szanyi, I, Lujber, L et al. Ionomer cement for reconstruction of the long process of the incus: the Pécs experience. Clin Otolaryngol 2008;33:116–20Google Scholar
4Siddiq, MA, East, DM. Long-term hearing results of incus transposition. Clin Otolaryngol Allied Sci 2004;29:115–18Google Scholar
5American Academy of Otolaryngology-Head and Neck Surgery Foundation. Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. Otolaryngol Head Neck Surg 1995;113:186–7Google Scholar
6Sismanis, A. Tympanoplasty. In: Glasscock, ME 3rd, Gulya, AJ, eds. Surgery of the Ear. Toronto: BC Decker, 2003;469–70Google Scholar
7Elsheikh, MN, Elsherief, H, Elsherief, S. Physiologic reestablishment of ossicular continuity during excision of retraction pockets: use of hydroxyapatite bone cement for rebridging the incus. Arch Otolaryngol Head Neck Surg 2006;132:196–9Google Scholar
8O'Reilly, RC, Cass, SP, Hirsch, BE, Kamerer, DB, Bernat, RA, Poznanovic, SP. Ossiculoplasty using incus interposition: hearing results and analysis of the middle ear risk index. Otol Neurotol 2005;26:853–8Google Scholar
9Goycoolea, MV. Tympanoplasty. In: Goycoolea, MV, Paparella, MM, Nissen, RL, eds. Atlas of Otologic Surgery. Philadelphia: WB Saunders, 1989;289Google Scholar
10Huttenbrink, KB, Luers, JC, Beutner, D. Titanium angular clip: a new prosthesis for reconstruction of the long process of the incus. Otol Neurotol 2009;30:1186–90Google Scholar
11Yung, M. Materials for ossicular chain reconstruction. In: Hildmann, H, Sudhoff, H, eds. Middle Ear Surgery. New York: Springer, 2006;49–61Google Scholar
12Schwager, K, Geyer, G. Titanium and glass-ionomer cement as ossicular replacement materials: biocompatibility results after implantation in the rabbit. ORL J Otorhinolaryngol Relat Spec 1998;60:322–8Google Scholar
13Glasscock, ME 3rd, Jackson, CG, Knox, GW. Can acquired immunodeficiency syndrome and Creutzfeldt-Jakob disease be transmitted via otologic homografts? Arch Otolaryngol Head Neck Surg 1988;114:1252–5Google Scholar
14Tos, M. Manual of Middle Ear Surgery. New York: Thieme Medical Publishers, 1993;1:285–301Google Scholar
15Emir, H, Kizilkaya Kaptan, Z, Göcmen, H, Uzunkulaoglu, H, Tuzuner, A, Bayiz, U et al. Ossiculoplasty with intact stapes: analysis of hearing results according to the middle ear risk index. Acta Otolaryngol 2009;129:1088–94Google Scholar
16Nikolaou, A, Bourikas, Z, Maltas, V, Aidonis, A. Ossiculoplasty with the use of autografts and synthetic prosthetic materials: a comparison of results in 165 cases. J Laryngol Otol 1992;106:692–4Google Scholar
17Fisch, U. Tympanoplasty, Mastoidectomy, and Stapes Surgery. New York: Thieme Medical Publishers, 1994Google Scholar
18Mann, W, Hoffmann, R. Tympanoplasty with incus interposition. Laryngol Rhinol Otol (Stuttg) 1988;67:31–3Google Scholar
19Albu, S, Babighian, G, Trabalzini, F. Prognostic factors in tympanoplasty. Am J Otol 1998;19:136–40Google Scholar
20Neudert, M, Zahnert, T, Lasurashvili, N, Bornitz, M, Lavcheva, Z, Offergeld, C. Partial ossicular reconstruction: comparison of three different prostheses in clinical and experimental studies. Otol Neurotol 2009;30:332–8Google Scholar
21Sanna, M, Gamoletti, R, Scandellari, R, Delogu, P, Magnani, M, Zini, C. Autologous fitted incus versus Plastipore PORP in ossicular chain reconstruction. J Laryngol Otol 1985;99:137–41Google Scholar
22Babu, S, Seidman, MD. Ossicular reconstruction using bone cement. Otol Neurotol 2004;25:98–101Google Scholar
23Celik, H, Aslan Felek, S, Islam, A, Demirci, M, Samim, E, Oztuna, D. The impact of fixated glass ionomer cement and springy cortical bone incudostapedial joint reconstruction on hearing results. Acta Otolaryngol 2009;129:1368–73Google Scholar
24Bayazit, YA, Ozer, E, Kanlikama, M, Durmaz, T, Yilmaz, M. Bone cement ossiculoplasty: incus to stapes versus malleus to stapes cement bridge. Otol Neurotol 2005;26:364–7Google Scholar
25Baglam, T, Karatas, E, Durucu, C, Kilic, A, Ozer, E, Mumbuc, S et al. Incudostapedial rebridging ossiculoplasty with bone cement. Otolaryngol Head Neck Surg 2009;141:243–6Google Scholar
26Ozer, E, Bayazit, YA, Kanlikama, M, Mumbuc, S, Ozen, Z. Incudostapedial rebridging ossiculoplasty with bone cement. Otol Neurotol 2002;23:643–6Google Scholar
27Reusche, E, Pilz, P, Oberascher, G, Lindner, B, Egensperger, R, Gloeckner, K et al. Subacute fatal aluminum encephalopathy after reconstructive otoneurosurgery: a case report. Hum Pathol 2001;32:1136–40Google Scholar
28Brask, T. Reconstruction of the ossicular chain in the middle ear with glass ionomer cement. Laryngoscope 1999;109:573–6Google Scholar
29Dere, H, Ozdogan, F, Ozcan, KM, Selcuk, A, Ozcan, I, Gokturk, G. Comparison of glass ionomer cement and incus interposition in reconstruction of incus long process defects. Eur Arch Otorhinolaryngol 2011;268:1565–8Google Scholar
30Demir, UL, Karaca, S, Basut, O. Bone cement or incus interposition in type 2 tympanoplasty: prognostic factors and functional outcomes [in English]. Kulak Burun Bogaz Ihtis Derg 2012;22:99–104Google Scholar
31Mishiro, Y, Sakagami, M, Kitahara, T, Kondoh, K, Kubo, T. Long-term hearing outcomes after ossiculoplasty in comparison to short-term outcomes. Otol Neurotol 2008;29:326–9Google Scholar
32Yung, M. Long-term results of ossiculoplasty: reasons for surgical failure. Otol Neurotol 2006;27:20–6Google Scholar