Medialized Total Ossicular Replacement Prosthesis

Polanik, Marc D; Remenschneider, Aaron K.

doi:10.1177/2473974x20916432

Cited by 2 publications

(1 citation statement)

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“…3 While extrusion is most common, prosthesis displacement into other areas of the middle and inner ear is possible. Displacement into the vestibule may present with fistula-type symptoms, namely vertigo and hearing loss, which has been previously described in a previous case of TORP medialization 4 and the stapedectomy literature. 5 Patients may be at increased risk of this complication if they have had prior middle ear surgery, including mastoid obliteration, or undergo mastoid obliteration at the same time as TORP placement, possibly due to distortion of anatomy.…”

Section: Discussionmentioning

confidence: 65%

Displacement of a Total Ossicular Replacement Prosthesis Following Ossicular Chain Reconstruction

Govindan

Bahethi

Schwam

et al. 2020

Ann Otol Rhinol Laryngol

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Objective: Herein we describe the diagnosis and management of total ossicular replacement prosthesis (TORP) displacement following tympanoplasty with ossicular chain reconstruction (OCR). Methods: Case report with literature review. Results/Case: A 40-year-old male with otorrhea and tympanic membrane perforation underwent a right revision tympanoplasty with OCR using a TORP with a tragal chondroperichondrial graft. On postoperative day (POD) 4, he developed vertigo and profound right-sided hearing loss. Temporal bone computed tomography showed the prosthesis in the vestibule. After a steroid taper with mild improvement in symptoms, the TORP was removed two weeks later and the patient continued to improve. Conclusion: TORP displacement into the vestibule is a very rare complication following OCR. Conservative management with high dose steroids may improve symptoms, however further middle ear exploration and surgical management may be warranted depending on the depth of displacement into the inner ear as well as symptom severity.

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Section: Discussionmentioning

confidence: 65%