Ossiculoplasty for Non-Inflammatory Ossicular Chain Destruction: Autologous Incus Graft Revisited

Introduction: The aim of this study is to compare the hearing outcomes of ossiculoplasty using an autograft incus and an ossicular replacement prosthesis for the management of ossicular chain malformations or traumatic ossicular injury.

Methods: We retrospectively analyzed patients who underwent ossiculoplasty in our department from January 2011 to December 2022 for ossicular malformation or destruction. Those who had inflammatory conditions or other middle ear pathology, and those who had follow up periods shorter than 3 months were excluded. Patients were divided into the synthetic or autologous group according to the surgical materials used. Audiometric outcomes were analyzed between the two groups. Air conduction thresholds, bone conduction thresholds, air bone gaps were measured preoperatively, and on the postoperative 3 months and 12 months.

Results: A total of 78 patients (82 ears) with ossicular chain malformation or discontinuity were enrolled (62 in the autologous group, 20 in the prosthesis group). Overall postoperative hearing threshold and air bone gap improved compared with the preoperative hearing threshold and air bone gap in both groups. A postoperative air bone gap closure to 20dB or less was achieved in 59 ears (45 in the autologous group, 14 in the prosthesis group). The improvements were not significantly different between the two groups.

Conclusions: Ossiculoplasty with both prosthesis and autologous materials demonstrated favorable hearing outcomes in ossicular malformations and traumatic ossicular injury.