Audiologic Results of Ossiculoplasty Using Malleus Footplate Assembly: The Comparison between Autologous Incus and Hydroxyapatite

A disruption of the ossicular chain of the middle ear causes conductive hearing loss. Ossicular reconstruction is performed to restore hearings in those patients with congenital ossicular chain anomaly or ossicular chain disruption caused by chronic otitis media or cholesteatoma. A study from Japan with 52 auditory ossicular malformation revealed that 44% of the patients had a fixation of the stapes, 40% had incudostapedial joint defects followed by fixation of the malleus and/or incus and defects in the incudostapedial joint with a fixation of the stapes. One of the most common ossicular chain anomalies in Korea was a stapes footplate fixation (54.5%) followed by a mobile stapes footplate with other anomalies (19.7%) including a stapes without suprastructure and an incus long process, stapes without anterior crus and an incus long process. One of the most common ossicular chain anomalies is the absence of an incus with or without an intact stapes suprastructure. In incudostapedial deformed ears, ossiculoplasty is mandatory to restore the hearing process. Ossiculoplasty is also needed in cases with incus long process erosion with inflammation. As the most vulnerable ossicles, one report said that incus erosion is found in 80% of the chronic otitis media. Austin-Kartush classified ossicular chain disruptions into four categories after 1,151 operation on chronic otitis media. Group A ears with an intact malleus handle and a stapes suprastructure was found in 59.2% followed by group B ears with an intact malleus handle but an eroded stapes suprastructure Audiologic Results of Ossiculoplasty Using Malleus Footplate Assembly: The Comparison between Autologous Incus and Hydroxyapatite