Title: OSSICULOPLASTY
1OSSICULOPLASTY
- Analysis of Results
- Dr.Jerry Halik MD FRCSC
2- N 133 (Total-209)
- Age 5-71
- Follow-up up to 71 months(2 years average)
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5Applebaum Incus Replacement Prosthesis(small)
- N 28
- Average age 41 years (18-67)
- Average follow-up 20 months(1-76)
6Applebaum Incus Replacement Prosthesis(small)-
Pre-op Diagnosis
- Chronic Otitis Media 25(89)
- Cholesteatoma 2
- Trauma 1
7Applebaum Incus Replacement Prosthesis(small)-Type
s of Repair
- Ossiculoplasty12(43)
- Ossiculoplasty with Tympanoplasty 14(50)
- With canal wall down Mastoidectomy and
Tympanoplasty2 (7)
8Applebaum Incus Replacement Prosthesis(small)-Resu
ltsA-B closurePossible SRTlt30 db23 post op
SRT lt30dB15/23(65)
0.5,1,2kHz 0.5,1,2,4kHz
lt 10dB 11/28 (39) 9/28 (32)
lt20dB 11/28 (39) 10/28 (36)
Total 22/28 (78) 19/28 (68)
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10Wehrs 2.7mm Incus Replacement Prosthesis
- N29
- Average age40 years(12-67)
- Average follow-up19 months(1-77)
11Wehrs 2.7mm Incus Replacement Prosthesis-Pre-op
Diagnosis
- Chronic Otitis Media 15 (52)
- Cholesteatoma 9 (31)
- Malleus Head Fixation 5(17)
12Wehrs 2.7mm Incus Replacement Prosthesis- Types
of Repair
- Ossiculoplasty12 (41)
- Ossiculoplasty with Tympanoplasty 10(34)
- With canal wall down Mastoidectomy and
Tympanoplasty 7(24)
13Wehrs 2.7mm Incus Replacement Prosthesis-Results
possible SRTlt30db25 Post op
SRTlt 30dB13/25(52)A-B Closure
0.5,1,2kHz 0.5,1,2,4kHz
lt10dB 10/29 (34) 9/29(31)
lt20dB 11/29(38) 12/29(41)
Total 21/29(72) 21/29(72)
14Wehrs 2.7mm Incus Replacement Prosthesis-Complica
tions
- Hearing worse 3 (10)
- Hyperacusis 1 (3)
15Wehrs mm Incus-Stapes Replacement Prosthesis
- N36
- Average age34 years (5-67)
- Average follow-up 25 months(1-66)
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17Wehrs Incus-Stapes Replacement Prosthesis-
Pre-op Diagnosis
- Chronic Otitis Media 16 (44)
- Cholesteatoma 18 (50)
- Congenital malformation2
18Wehrs 2.7mm Incus-Stapes Replacement
Prosthesis-Type of repair
- Ossiculoplasty 11(31)
- Ossiculoplasty with Tympanoplasty13(36)
- With canal wall down Mastoidectomy and
Tympanoplasty 12(33)
19Wehrs Incus-Stapes Replacement Prosthesis-
Resultspossible
SRTlt30db32 Post op SRTlt
30dB19/32(59)A-B Gap Closure 1
overclosure
0.5,1,2kHz 0.5,1,2,4kHz
lt10dB 16/36(44) 11/36(31)
lt20dB 10/36(28) 12/36(33)
Total 26/36(72) 23/36(64)
20Wehrs 2.7mm Incus-Stapes Replacement
Prosthesis-Complications
- Hearing worse 1
- Extrusion 1 (4 years)
- Dislocation 1
21Malleus-Stapes Assembly
- N26
- Average age 37 years (12-71)
- Average follow-up22 months(1-63)
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23Malleus-Stapes Assembly-Pre-op Diagnosis
- Chronic Otitis Media 16 (62)
- Cholesteatoma6 (23)
- Trauma 1
- Malleus Head Fixation 3
24Malleus-Stapes Assembly-Types of Repair
- Ossiculoplasty 12(46)
- Ossiculoplasty with Tympanoplasty10(38)
- With canal wall down Mastoidectomy and
Tympanoplasty 4
25Malleus-Stapes Assembly-ResultsA-B gap closure
Possible SRTlt30dB 22 Post-op SRtlt30dB 11/22
(50)
0.5,1,2kHz 0.5,1,2,4kHz
lt10dB 3/26(12) 2/26(8)
lt20dB 8/26(31) 10/26(38)
Total 11/26(42) 12/26(46)
26Malleus-Stapes Assembly-Complications
27Assemblies- Total (N119)
- Pre-op diagnosis
- Chronic Otitis Media 72(61)
- Cholesteatoma35(29)
- Trauma2
- Malleus Head Fixation8
- Congenital2
28Assemblies-Types of repair
- Ossiculoplasty 47 (39)
- Ossiculoplasty with Tympanoplasty47(39)
- Ossicuplasty withTympanoplasty and canal wall
down Mastoidectomy 25(21)
29Assemblies-ResultsA-B gap closurepossible
SRTlt30dB102 Post oplt30dB58/102(57) 1
overclosure
0.5,1,2kHz 0.5,1,2,4kHz
lt10dB 40/119(34) 31/119(76)
lt20dB 40/119(34) 44/119(37)
Total 80/119(68) 75/119(63)
30Assemblies-Complications
- Hearing worse 8(7)
- Hyperacusis 1
- Extrusions 1
- Dislocation 1
31Torps and Porps
- N14
- Average age40 years.(4-65)
- Average follow-up21 months(6-49)
32Torps and Porps- Pre-op Diagnosis
- Chronic otitis media8(57)
- Cholesteatoma 4(29)
- Congenital malformation 1
- Malleus head fixation1
33Torps and Porps- Types of Repair
- Ossiculoplasty2
- Ossiculoplasty with Tympanoplasty11(79)
- With canal wall down Mastoidectomy and
Tympanoplasty 1
34Torps and Porps- Results A-B gap
closurepossible Satlt30dB12 Post op
Satlt30dB4/12(25)
0.5,1,2kHz 0.5,1,2,4kHz
lt10dB 2/14(14) 1/14(7)
lt20dB 6/14(43) 5/14(36)
Total 8/14(57) 6/14(43)
35Torps and Porps Complications
36Conclusions
- Assemblies better than torps and porps(60 vs
25 success) - ?Effectiveness of malleus-stapes assembly
- ?which prosthesis
- Safe
- Long term results problematic
- Single stage procedures reasonable
- ?Cost effective
- ?Use of aids after failure