Usefulness of a ventilation tube as a partial ossicular replacement prosthesis (PORP) in ossiculoplasty in patients with chronic otitis media
Maciej Wiatr, Jacek Składzień, Jerzy Tomik, Paweł Stręk
(Department of Otolaryngology, Head and Neck Surgery, Jagiellonian University, Cracow, Poland)
Med Sci Monit 2014; 20:974-979
The principal objective of ossiculoplasty is to reconstruct the sound-conducting system in the ear to the best possible degree after the elimination of pathological lesions from the middle ear. The ossicular chain is reconstructed with the use of the patient’s own properly modelled ossicles and synthetic prostheses. The objective of the study was to assess the degree of hearing improvement after tympanoplasty in patients for whom a ventilation tube was used as a partial ossicular replacement prosthesis (PORP).
Material and Methods: Between 2009 and 2012, 387 patients underwent ear surgery at the Otolaryngological Teaching Hospital of the Collegium Medicum at the Jagiellonian University of Cracow. We focussed on the patients in whom a vibrating element in the form of a properly modelled anvil or a ventilation tube was attached to the preserved and normally mobile stapes.
Results: A significant hearing improvement was observed in patients with type 2 tympanoplasty in the course of chronic cholesteatoma otitis media and in patients with simple chronic inflammatory process in whom a ventilation tube was used as a PORP in the reconstruction. Granulation tissue was determined to be an unfavorable factor in the prognosis of hearing improvement following tympanoplasty.
Conclusions: Significant hearing improvement was observed after type 2 tympanoplasty in patients with cholesteatoma whose ossicular chain was not appreciably damaged. A ventilation tube used as a PORP is an effective alternative in the reconstruction of the ossicular chain.
Keywords: Humans, Chronic Disease, Middle Ear Ventilation, Mucus - secretion, Ossicular Prosthesis, Otitis Media - surgery, Otologic Surgical Procedures - methods, Treatment Outcome, Tympanoplasty