Long-term Results of the Cartilage Shoe Technique to Anchor a Titanium Total Ossicular Replacement Prosthesis on the Stapes Footplate After Type III Tympanoplasty

Gostian, Antoniu‐Oreste; Kouame, Jean-Marc; Bremke, Martin; Ortmann, Magdalene; Hüttenbrink, Karl-Bernd; Beutner, Dirk

doi:10.1001/jamaoto.2016.2118

Cited by 13 publications

(10 citation statements)

References 28 publications

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“…After CWD surgery (n ¼ 18), the PTA-ABG was reduced from a mean (SD) of 33.0 dB to 24.6 dB. 14 In our study, the stable assembly made by the boomerang shape and its one end hitching below the inferior annulus is believed to overcome the aforementioned 'transmission block'.…”

Section: Discussionmentioning

confidence: 52%

Effect of a boomerang-shaped Conchal cartilage graft for Type three Tympanoplasty on Hearing

Elaprolu

Alexander

Ganesan

et al. 2020

Int Arch Otorhinolaryngol

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Abstract Introduction Chronic suppurative otitis media atticoantral disease (CSOM-AAD) is often associated with ossicular erosion resulting in significant hearing loss. Absence of the stapes suprastructure is a poor prognostic indicator of hearing outcome, which necessitates an effective reconstruction technique for ossicular continuity and restoration of middle ear volume. In the present study, we used a boomerang-shaped conchal cartilage graft. Objective To evaluate the improvement in hearing using a boomerang-shaped conchal cartilage graft for Type III tympanoplasty in cases of CSOM-AAD in which the stapes suprastructure was absent and to study the incidence of intraoperative/postoperative complications of this procedure. Method A total of 21 patients with CSOM-AAD who were found to have absent stapes suprastructure intraoperatively were included. A boomerang-shaped conchal cartilage graft was placed over the stapes footplate for reconstruction following canal wall down mastoidectomy. Pure tone audiogram (500, 1,000, 2,000 and 4,000 Hz) was done preoperatively and at 12 weeks postoperatively. Hearing outcome and incidence of complications were noted. Results There was a statistically significant reduction in the hearing loss for air conduction and air-bone gap (ABG) of 6.1 dB and 6.9 dB respectively (p < 0.05). Air-bone gap < 30 dB could be achieved in 71.4% of the patients as compared with 23.8% preoperatively. No significant difference was noted in the bone conduction threshold (p > 0.05). A better hearing outcome was observed at higher frequencies (2,000, 4,000 Hz). No major complications were encountered. Conclusion A boomerang-shaped conchal cartilage graft is effective when used for Type III tympanoplasty, especially at higher (2,000, 4,000 Hz) frequencies, and is comparable to newer materials such as titanium total ossicular reconstruction prosthesis (TORP). No major intraoperative/postoperative complications were noted.

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Section: Discussionmentioning

confidence: 52%

Effect of a boomerang-shaped Conchal cartilage graft for Type three Tympanoplasty on Hearing

Elaprolu

Alexander

Ganesan

et al. 2020

Int Arch Otorhinolaryngol

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“…Vincent et al described the repositioning of the malleus in ossicular chain reconstruction leading to better audiological outcomes . Placement of a cartilage shoe has shown to prevent slippage of the TORP off the footplate . Cartilage shoe placement was done in every case of TORP ossiculoplasty in our study.…”

Section: Discussionmentioning

confidence: 71%

“…10 Placement of a cartilage shoe has shown to prevent slippage of the TORP off the footplate. 11 Cartilage shoe placement was done in every case of TORP ossiculoplasty in our study. The placement of the prosthesis was technically easier via the endoscopic technique by virtue of clearer visualization of the working area.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ossiculoplasty: Is there any edge over the microscopic technique?

et al. 2019

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Objectives/Hypothesis To compare endoscopic ossiculoplasty with conventional microscopic technique in terms of postoperative hearing outcomes and complications. Study Design Randomized controlled trial. Methods One hundred eighteen patients diagnosed with ossicular chain discontinuity were randomly assigned into two groups, one undergoing endoscopic ossiculoplasty and the other undergoing ossiculoplasty by the microscopic technique, with the operating surgeon being same for both groups. The two groups were compared in terms of operative time, postoperative air‐bone gap, mean air‐bone gap closure, and incidence of complications. Teflon prostheses (partial ossicular chain replacement prosthesis [PORP] and total ossicular chain replacement prosthesis [TORP]) were used for reconstruction in all cases. Results Endoscopic ossiculoplasty with PORP rendered a statistically significant mean postoperative air‐bone gap and air‐bone gap closure at 1 month when compared to that of microscopic PORP ossiculoplasty. However, there was no significant difference between the two techniques in terms of mean postoperative air‐bone gap and air‐bone gap closure at 3 and 6 months. In the TORP ossiculoplasty cases, there was no significant difference in mean postoperative air‐bone gap and air‐bone gap closure at 1, 3, and 6 months. In terms of operative time and incidence of complications, no statistical significance was found between the two groups. Conclusions Endoscopic ossiculoplasty appears to provide superior visualization and better early audiological outcome (in PORP ossiculoplasty cases) when compared to microscopic technique. However, long‐term audiological outcomes and incidence of complications remain comparable. Level of Evidence 1 Laryngoscope, 130:797–802, 2020

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“…These findings suggest that the prosthesis should be fixated with a cartilage block to the base of the stapes. Recently, Gostian et al (27) reported the results of a 6.8year follow-up of patients with cartilage shoe application. With these results, it may be thought that cartilage shoe application is a reliable method that is not negatively affected by the middle ear pathology.…”

Section: Discussionmentioning

confidence: 99%

Audiological Results of Total Ossicular Replacement Prosthesis with Cartilage Shoe Technique

Kaplankıran

Ceylan

Yildirim

et al. 2018

Turk Arch Otorhinolaryngol

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Long-term Results of the Cartilage Shoe Technique to Anchor a Titanium Total Ossicular Replacement Prosthesis on the Stapes Footplate After Type III Tympanoplasty

Abstract: The use of the cartilage shoe that anchors a titanium TORP on the stapes footplate can be advocated for good and reliable long-term results after total ossiculoplasty.

Cited by 13 publications

References 28 publications

Effect of a boomerang-shaped Conchal cartilage graft for Type three Tympanoplasty on Hearing

Effect of a boomerang-shaped Conchal cartilage graft for Type three Tympanoplasty on Hearing

Endoscopic ossiculoplasty: Is there any edge over the microscopic technique?

Audiological Results of Total Ossicular Replacement Prosthesis with Cartilage Shoe Technique

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