Extrusion rates and hearing results in ossicular reconstruction

OBJECTIVES: To examine hearing results, extrusion rates, and factors likely to affect outcome in patients who underwent ossicular chain reconstruction with Plasti-Pore and hydroxylapatite total ossicular replacement prosthese s (TORPs) and partial ossicular replacement prosthesis (PORPs). STUDY DESIGN AND SETTING: Retrospective chart review was used. Subjects wer e 1210 consecutive tympanoplasties with or without mastoidectomy that invol ved ossicular reconstruction with TORPs (n = 560) or PORPs (n = 650) perfor med in a tertiary referral neurotologic private practice. Only 20% of the c ases were primary surgeries, with the majority planned second stage or revi sion procedures. RESULTS: Average last postoperative air-bone gap (ABG) was 19.2 dB with clo sure of the ABG to within 20 dB in 62.9%. Hearing results were better for c ases who had. not had previous surgery, in those with a diagnosis other tha n chronic otitis media, when a cartilage graft was used, and for Plasti-Por e rather than hydroxylapatite. Extrusion was known to occur in 4%. CONCLUSION: After more than 25 years of use in our clinic, Plasti-Pore ossi cular replacement prostheses continue to provide reliable hearing results w ith a low rate of extrusion.