A STUDY TO EVALUATE THE HEARING EFFICACY OF BONE CEMENT OSSICULOPLASTY FOR INCUDOSTAPEDIAL REBRIDGING

Background:The goal of surgery in cases with chronic otitis media both safe and unsafe types is to achieve a maximal disease clearance and restore the near normal hearing. Various techniques of ossiculoplasty have been used to reconstruct the eroded ossicular chain. The ideal material to be employed in ossiculoplasty techniques should be bio active, bio compatible, safe, stable and with easier to apply. Hydroxyapatite, which is a calcium phosphate compound bone cement is similar in composition to living human bone and satisfies all the all above characteristics of an ideal ossiculoplasty material. Objectives:The purpose of this study is to evaluate the hearing outcomes of hydroxyapatite bone cement ossiculoplasty done in patients with incudostapedial erosion in both safe and unsafe types of chronic otitis media. The study is also aimed to determine the ideal candidates for bone cement ossiculoplasty. Methodology:A total of thirty patients of chronic otitis media with incudostapedial erosion were included in the study. Patients underwent ossicular reconstruction with hydroxyapatite bone cement. Preoperative and post operative hearing results with pure tone audiogram and impedance audiometry were recorded. One year period of follow up was done and reduction in air bone gap was analyzed. Results:The post operative air bone gap was found to be significantly reduced after a period of follow up of one year. The mean preoperative and postoperative pure tone averages was found to be 47.46 and 36.86 respectively. The mean preoperative and post operative air bone gaps were 37.89 and 27.28 respectively with p<0.001. No complications were recorded during the study in relation to the bone cement. Conclusions:Incudostapedialrebridgingossiculoplasty with hydroxyapatite bone cement is a safe and reliable method that is cost effective and provides significant hearing outcomes in selected patients with no complications recorded.