Incudostapedial rebridging ossiculoplasty with bone cement

The goals of surgery for chronic ear disease are eradication of the disease and reconstruction of a sound transformer mechanism. Erosion of the incudostapedial joint with an intact mobile malleus is the most common ossicular defect encountered in chronic middle ear disease. Various techniques are available for reconstruction of ossicular defect. Total (TORP) or partial ossicular replacement prostheses (PORP), otogen bone grafts, homogen bone grafts, or cortical bone grafts are materials that have been used for years. Problems with these materials are high extrusion rates and risk of dislocation, which may result in recurrent conductive hearing loss. ISRO with bone cement has some advantages such as satisfactory hearing results, ease of application, and cost effectiveness . 37 years female came with hard of hearing right ear for past 2 years. On examination bilateral TM intact. PTA and impedence audiometry was done. Right conductive hearing loss with airbone gap 35.6 dB HL identified. Patient underwent exploratory tympanotomy. Incudostapedial joint identified intraoperatively , stabilized with glass ionomer bone cement. Post operative air bone gap evaluated after 6 months. A postoperative air-bone gap less than 20 dB was achieved. Hearing results with bone cement ossiculoplasty are satisfactory.