Comparison of glass ionomer cement and incus interposition in reconstruction of incus long process defects

Abstract

The ossicles may be affected through the mass effect of the pathological tissue in chronic otitis media. Ossicular reconstruction may be accomplished using the patients' own ossicles or with alloplastic materials. Glass ionomer ossiculoplasty is a fast, efficient, safe and cost-effective method and it has been used more frequently in recent years. Forty-six patients who had surgery for chronic otitis media were included in this study. All patients had an incus long process defect and a normal stapes superstructure. Ossicular reconstruction was performed using glass ionomer cement (GIC) (Ketac-Cem, Espe Dental AG, Seefeld, Germany) in 23 patients (group 1), while incus interposition was performed in other 23 patients (group 2). Preoperative and postoperative air pure tone averages of the group 1 patients were 42.8 and 35.2 dB, respectively (p < 0.01). These values were 42.9 and 34.5 dB in group 2 (p < 0.01). Two groups were similar with respect to postoperative hearing gain (p > 0.05). The air bone gap of group 1 was 27 dB preoperatively and 20.7 dB postoperatively. These values were 28.7 and 20.2 dB, respectively, in group 2. The closure of air bone gap was statistically significant in both the groups (p < 0.01, p < 0.01). The comparison of the mean gains of the air bone gap revealed no difference between the groups (p > 0.05). In conclusion, the use of both GIC ossiculoplasty and incus interposition are efficient methods for reconstruction of incus long process and one is not superior to the other. A larger study population may be useful for comparison of these methods.

Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling

“…Unfortunately, long-term mean ABG (at 12 months) in our incus interposition control group (23.1 dB) was not as favourable as results reported by other authors, such as Dere et al [18] (20 dB), Emir et al [19] (20.4 dB) and O'Reilly et al (18.6 dB) [11].…”

Is it the Middle Ear Disease or the Reconstruction Material That Determines the Functional Outcome in Ossicular Chain Reconstruction?

“…In some previous studies, the glass ionomer cement and incus interposition were also compared. Dere et al (23) found that the use of bone cement and incus interposition resulted in similar significant hearing results (i.e., ABG gain of 6.3 and 8.5 dB, respectively). In their study where the efficacy of incus interposition, PORP, and bone cement in isolated incudostapedial disarticulation was compared, Babu and Seidman (7) showed significant postoperative hearing improvements in all cases.…”

Résultats fonctionnels préliminaires des ossiculoplasties par ciment d’hydroxylapatite et comparaison avec les autres matériaux d’ossiculoplastie partielle

“…La comparaison du ciment osseux ionomérique avec les autres matériaux d'ossiculoplasties partielles a été également faite et conclue à sa non-infériorité, notamment sur les transpositions d'enclume [2,23] ou les prothèses en titane [20], avec des résultats audiométriques au moins équivalents. Cependant, la neurotoxicité connue de l'aluminium (composant en partie le ciment ionomé-rique) [7] et des cas d'encéphalopathie aluminique, allant jusqu'au décès des patients [8,24], secondaires à son utilisation ont été décrits dans la littérature ; et même si d'autres études ont montré une bonne tolérance à long terme [9], ces risques sont à prendre en considération dans le choix du matériau de reconstruction ossiculaire.…”