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Comparative Evaluation of Hearing in Cartilage Umbrella, Boomerang and Torp in Chronic Otitis Media Cases with Absent Stapes Suprastructure: Our Experience

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Abstract

Ossicular discontinuity is one of the most common causes of conductive hearing loss. Ossicular chain reconstruction improves conductive hearing loss. With no additional cost, cartilage ossiculoplasty is easy to perform, and also the cartilage is well tolerated being an autograft. In this study we compared the audiological outcome in ossiculoplasty done by cartilage umbrella, cartilage boomerang and alloplastic TORP. 75 patients of age group 10–50 years clinically diagnosed with chronic otitis media with conductive hearing loss and an air bone gap (ABG) of at least 20 dB posted for surgery were included. Ossiculoplasty was done in three groups with autologous cartilage boomerang, cartilage umbrella and alloplastic TORP. In mucosal disease hearing gain was better in umbrella technique (17.66 ± 1.1) dB than Boomerang (16.9 ± 0.8) dB and TORP (10.68 ± 0.9) dB. ABG closure was higher in Boomerang and TORP. Hearing improvement in patients with squamosal disease managed by canal wall up surgery was 25.01 ± 1.1 dB, 27.73 ± 3.1 dB and 20.12 ± 1.8 dB in Boomerang, Umbrella and TORP group respectively showing that umbrella method gave maximum improvement. ABG closure was better in TORP group. In canal wall down surgery patient’s maximum improvement was seen in Boomerang (29.51 ± 0.9) dB followed by Umbrella (26.67 ± 1.2) dB and TORP (25.27 ± 0.8) dB group. ABG closure was higher in Boomerang group. Cartilage ossiculoplasty is a reliable and effective method of ossicular chain reconstruction for both mucosal and squamosal disease. Cartilage ossiculoplasty has the added advantage of reduced chances of prosthesis extrusion as compared to TORP.

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References

  1. Mahanty S, Maiti AB, Naskar S, Das SK, Mandal S, Karmakar M (2015) A comparative study of outcome of ossicuoloplasty using cartilage graft, bone and different alloplasts in chronic otitis media. Indian J Otol 21(2):144–148

    Article  Google Scholar 

  2. Wullstein H (1956) Theory and practice of tympanoplasty. Laryngoscope 66(8):1076–1093. https://doi.org/10.1288/00005537-195608000-00008

    Article  CAS  Google Scholar 

  3. Sharma K, Gururani P, Arora A, Singh G (2017) Role of autologous versus homologous cartilage in ossicular reconstruction: a comparative study. Indian J Otolaryngol Head Neck Surg 69(2):137–141

    Article  Google Scholar 

  4. Guler I, Kum RO (2019) Management of Incus defects in children: Comparison of Incus transposition versus glass inomer cement. Ear Nose Throat J. https://doi.org/10.1177/0145561319856325

    Article  Google Scholar 

  5. Khan MM, Parab SR (2021) Endoscopic cartilage umberlla ossiculoplasty: as total ossicular replacement using endoscope holder. Indian J Otolaryngol Head Neck Surg. https://doi.org/10.1007/s12070-021-02518-8

    Article  Google Scholar 

  6. Rana AK, Sharma R, Sharma VK, Mehrotra A, Upadhyay D (2020) Intraoperative tragal and conchal cartilage thickness: comparative study for cartilage tympanoplasty. Am J Otolaryngol 41(6):102690. https://doi.org/10.1016/j.amjoto.2020.102690

    Article  Google Scholar 

  7. Parab SR, Khan MM, Rana AK (2020) Accurate and specific measuring grid for otorhinolaryngological surgeries. Indian J Otolaryngol Head Neck Surg. https://doi.org/10.1007/s12070-020-01886-x

    Article  Google Scholar 

  8. Parab SR, Khan MM (2018) New cartilage slicer for slicing techniques in tympanoplasty: Design and applications. Indian J Otolaryngol Head Neck Surg 70(4):515–20. https://doi.org/10.1007/s12070-018-1467-4

    Article  Google Scholar 

  9. Adhikari P, Joshi S, Baral D, Kharel B (2009) Chronic suppurative otitis media in urban private school of Nepal. Braz J Otolaryngol 75(5):669–672

    Google Scholar 

  10. Ayache D, Manach F, Teszler CB, Mathieu V, Bakkouri W, Corre A et al (2017) Cartilage ossiculoplasty from stapes to tympanic membrane in one stage intact canal wall tympanoplasty for cholesteatoma. J Int Adv Otol 13(2):171–175

    Article  Google Scholar 

  11. Desarda KK, Bhisegaonkar DA, Gill S (2005) Tragal perichondrium and cartilage in reconstructive tympanoplasty. Indian J Otolaryngol Head Neck Surg 57(1):9–12

    Article  CAS  Google Scholar 

  12. Singh VP, Sharma N, Bansal C (2017) Comparison of myringostapediopexy and malleostapediopexy tympanoplasty with sculptured incus in case of hearing reconstruction in tubotympanic chronic otitis media: a case series. Indian J Otol 23(3):189–192

    Article  Google Scholar 

  13. Quaranta N, Taliente S, Coppola F, Salonna I (2015) Cartilage tympanoplasty in cholesteatoma surgery: hearing results and prognostic factors. Acta Otorhinolaryngol Ital 35:338–342

    Article  CAS  Google Scholar 

  14. Bojrab DI, Kartush JM, Bouchard KR (1990) Surgery of the ear. WB Saunders Co., Philadelphia, pp 351–369

    Google Scholar 

  15. Brackmann DE, Sheely JL (1979) Tympanoplasty with TORP and PORPs. Laryngoscope 89:108–114

    CAS  Google Scholar 

  16. Jha S, Mehta K, Prajapati V, Patel D, Kharadi P (2011) A comparative study of ossiculoplasty by using various graft materials. National J Integrated Res Med 2(4):53–57

    Google Scholar 

  17. Gardner EK, Jackson CG, Kaylie DM (2004) Results with titanium ossicular reconstruction prostheses. Laryngoscope 114:65–70

    Article  CAS  Google Scholar 

  18. Acharya SK, Pahuja OP, Chamyal PC (1994) Middle ear reconstruction- our experience. Med J Armed Forces India 50(2):113–116

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Authors wish to thank Dr. Deviprasad Dosemane, Associate Professor, Department of ENT, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore (India) for his valuable suggestions during preparation of this manuscript.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head Neck Surgery, SRMS Institute of Medical Sciences, Bareilly, India

    Amit Kumar Rana

  2. Department of ENT, Career Institute of Medical Sciences and Hospital, Lucknow, India

    Shivesh Kumar

  3. Department of ENT, BPS Government Medical College, Khanpur, Sonipat, India

    Amit Kumar

  4. Sushrut ENT Hospital and Dr. Khan’s ENT Research Centre, Talegaon DabhadeTalegaon, Pune, India

    Mubarak Muhamed Khan & Sapna Ramakrishna Parab

  5. Department of Community Medicine, Rohilkhand Medical College and Hospital, Bareilly, India

    Deepak Upadhyay

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  1. Amit Kumar Rana
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  2. Shivesh Kumar
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  3. Amit Kumar
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  4. Mubarak Muhamed Khan
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  5. Sapna Ramakrishna Parab
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  6. Deepak Upadhyay
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Correspondence to Amit Kumar Rana.

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Rana, A.K., Kumar, S., Kumar, A. et al. Comparative Evaluation of Hearing in Cartilage Umbrella, Boomerang and Torp in Chronic Otitis Media Cases with Absent Stapes Suprastructure: Our Experience. Indian J Otolaryngol Head Neck Surg 74 (Suppl 3), 4069–4076 (2022). https://doi.org/10.1007/s12070-021-02819-y

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