gms | German Medical Science

Purpose: The purpose was to study the hearing results in patients receiving a Kurz titanium Bell partial ossicular replacement prosthesis (PORP) or an Aerial total ossicular replacement prosthesis (TORP). The study was a retrospective chart review. All operations were performed for cholesteatoma.

Material and method: Our otologic database was used to identify 56 patients implanted with either a PORP or TORP prosthesis between January 2004 and July 2007. Audiograms were reviewed and airbone gaps were calculated for each patient. The improvement of the average air-bone gap (ABG) was 8.5 and 11.2 dB at 6 and 18 months after ossiculoplasty, respectively. 53% of patients (30/56) had a postoperative air-bone gap of 20 dB or less. The ABG for the titanium PORP prosthesis was 15.1±9.3 dB, compared with 27.2±12.1 dB for the TORP prosthesis ( P <0.05).

Results: The ABG to within 20 dB or less was obtained in the PORP group in 61% of the cases, versus 37% of the cases in the TORP group ( P<0.05). Two extrusions of the prostheses were observed at 14 and 16 months after surgery (3,6%). Revision procedures for functional failure were carried out in 11 patients (19%). The rate of sensorineural hearing loss was 3.6%. The major factors influencing good audiometric results were the surgical procedure preserving the external auditory canal and the presence of the stapes. The best hearing results were achieved when a PORP was used in a closed technique, and the worst hearing results were achieved when a TORP was used in an open procedure.

Conclusion: The titanium Kurz prosthesis has been an effective implant at our institution for ossicular reconstruction.

Key Words: cholesteatoma surgery, titanium ossicular replacement prosthesis.