The contrastive analysis of 60 cases of ossicular chain reconstruction using different replacement prostheses

Objective To compare the hearing improvement, operation time and cost of surgery with autologous ossicular chain or synthetic prostheses by a retrospective analysis. Methods The study investigated 60 cases of patients underwent typeⅢa tympanoplasty with autologous incus, plastipore prosthesis, or titanium partial ossicular replacement prosthesis (PORP), including 32 cases with wall up tympanoplasty and 28 cases with wall down tympanoplasty. The average postoperative air-bone gaps (ABG) were measured at four frequencies: 0.5, 1, 2, and 4 kHz. Results As for the wall up tympanoplasty, the postoperative ABG in autologous incus group, plastipore group and titanium group were significantly reduced by 16.7 ± 15.0 dB, 18.8 ± 15.3 dB, and 14.7 ± 7.7 dB, respectively. But there was no significant difference in hearing improvement among these groups. As for the wall down tympanoplasty, the hearing improvement in the autologous incus group was less than other groups. There was no significant difference in operation time among three groups. The medical cost in autologous incus was the lowest and the titanium group was the highest. Conclusions Both autologous and artificial ossicular reconstruction could be valuable for improving hearing. The medical cost was lowest in autologous incus group, but the hearing improvement was better in synthetic prostheses group than that in autologous incus group with the wall down tympanoplasty.