Nagenahlli Siddappa Prakash, Poojar Jayakumar Puneeth, Jonnalagadda Dheeraj Kumar
1Department of ENT, J.J.M Medical College, MCC B Block, Davangere, Karnataka 577004 India.
2Department of ENT, J.J.M Medical College, Davangere, India.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1431-1435. doi: 10.1007/s12070-018-1514-1. Epub 2018 Oct 19.
Ossiculoplasty is one of the commonly done and challenging surgery in otology and has been done using various graft materials. Materials such as autologous cartilage (tragal or conchal) or allograft (homograft) of the same tissue and synthetic materials like polyethylene TORP, ceramic and hydroxyapatite PORP or Titanium prosthesis have been used. But the latter synthetic materials are expensive and have high extrusion rates. Autologous cartilage grafts are selected for Ossiculoplasty as they are easy to harvest at the same site of operation, non-toxic, has less extrusion rate, minimum shrinkage and lateralization. The aim of this study is to know the efficacy of cartilage in ossicular reconstruction and to evaluate hearing outcome. It is a prospective study done on patients attending ENT outpatient department at hospitals attached to J.J.M Medical College, Davanagere. 50 patients were included in the study who underwent ossicular reconstruction either with canal wall up or down mastoidectomy with tympanoplasty. Pre-operative mean ABG was 39.3 db whereas 6 months post-operative mean ABG was 31.6 db with mean ABG improvement of 7.7 db which was statistically significant. Hearing improvement is better in cases where stapes suprastructure was present and also in canal wall up mastoidectomy procedures. This study suggests that cartilage graft (tragal and conchal) is effective in cases of ossicular reconstruction in patients of chronic otitis media and gives good hearing gain. It is also a economical option in developing countries.
听骨链成形术是耳科学中常见且具有挑战性的手术之一，已使用多种移植材料进行。已使用的材料包括自体软骨（耳屏或耳甲）或相同组织的同种异体移植（同种移植）以及合成材料，如聚乙烯全听骨赝复物、陶瓷和羟基磷灰石部分听骨赝复物或钛假体。但后几种合成材料价格昂贵且脱出率高。自体软骨移植被选用于听骨链成形术，因为它们易于在手术同一部位获取，无毒，脱出率低，收缩和移位最小。本研究的目的是了解软骨在听骨重建中的疗效并评估听力结果。这是一项对在达瓦纳盖雷J.J.M医学院附属医院耳鼻喉科门诊就诊的患者进行的前瞻性研究。50例接受了耳道上壁或下壁乳突根治术加鼓室成形术的听骨重建患者被纳入研究。术前平均气骨导差为39.3分贝，而术后6个月平均气骨导差为31.6分贝，平均气骨导差改善了7.7分贝，具有统计学意义。在镫骨上部结构存在的病例以及耳道上壁乳突根治术手术中听力改善更好。本研究表明，软骨移植（耳屏和耳甲）在慢性中耳炎患者听骨重建病例中有效，并能带来良好的听力增益。在发展中国家，这也是一种经济的选择。
