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Amith Naragund

Amith Naragund

KLE UNIVERSITY, India.

Title: Autologous Incus Versus Titanium Partial Ossicular Replacement Prosthesis In reconstruction of Austin Type A Ossicular Defects- A Prospective Randomized Clinical trial.

Biography

Biography: Amith Naragund

Abstract

Objectives: To evaluate the hearing (functional outcome) and graft take up (anatomical outcome) after ossiculoplasty with autograft incus and titanium partial ossicular replacement prosthesis (PORP) in Austin type A  ossicular defects and ii) to compare the outcomes of autologous incus interposition ossiculoplasty with titanium PORP

Materials and Methods: This study was conducted on 40 patients in the age group of 10 and 60 years having chronic otitis media with Austin type A ossicular defect who underwent ossiculoplasty. The patients were randomly divided into 2 groups; group A who underwent ossiculoplasty by inter-positioning of autologous incus and group B in whom titanium PORP was used. Otoscopic examination and audiological assessment with conventional pure tone audiometery was done pre and post operatively at 3, 6 and 12 months.

Results: Average post-operative air bone gap (ABG) closure of less than 20 dB was considered as successful hearing gain which was seen in 13 (65%) patients in group A and 07 (35%) in group B.

The average pre-operative ABG value in group A (autologous incus) and group B (PORP) were 42.14+ 6.96 and 44.37+ 9.54 respectively and average post-operative ABG closure after 3 months was 24.23+ 8.50 and 13.05+ 12.46 in group A & B  respectively.

The post-operative complications were also much less in group A (20%) as compared to group B (45%). A longer follow up after 6 and 12 months post-operatively did not show any difference in hearing outcome and graft take up.

Conclusion:The hearing results and graft take up rate after ossiculoplasty with autologous incus is significantly better than titanium PORP in reconstruction of Austin A type of ossicular defects. The major disadvantages for the use of titanium PORP is its unpredictable results and higher post-operative complications and extrusion rates as compared to autologous incus.