Abstract
Objectives: Tympanoplasty is a well-established procedure for the reconstruction of the sound-conducting system in the middle ear disease. However, hearing result is not always satisfactory, especially in Type III and/or IV tympanoplasty. One of the major causes of this failure is the displacement of substitute for ossicles. Therefore this study aimed to evaluate the efficacy of a new technique for stabilization of columella in Type III and IV tympanoplasty.
Methods: Hydroxylapatite total or partial ossicular replacement prosthesis was applied for reconstruction of the osssicular chain. A trimmed cartilage that was harvested from the autologous auricle was glued on the head of the prosthesis. The entire unit was placed between the stapes or its footplate and the tympanic membrane. A harvested autologous temporal fascia was trimmed into a string (2 × 20 mm). This string was put around the neck of the prosthesis like a muffler. Then both ends of string were attached to the surrounding bone walls by fibrin glue.
Results: Fifty-five patients underwent this new tympanoplasty technique for 3 years. Hearing success was defined as a postoperative pure-tone average air-bone gap of <10 dB. Overall success rates in Type III and IV tympanoplasty were 87.1% (27/31) and 83.3% (20/24), respectively. Patients were followed for more than 6 months. Sensorineural hearing loss and more adverse events did not occur.
Conclusion: High success rates of hnearing improvement and of stabilization of columella in Type III and IV tympanoplasty can be achieved by this new technique.