[Ossiculoplasty with a partial Spiggle & Theis titanium prosthesis in cholesteatoma: functional results]

F Espitalier, O Malard, R Wagner, S Bailleul, P Bordure
Annales D'oto-laryngologie et de Chirurgie Cervico Faciale 2008, 125 (5): 243-9

OBJECTIVES: To report the functional results of ossicular reconstruction achieved with a specific partial prosthesis in tympanoplasty for cholesteatoma.

MATERIALS AND METHODS: Forty-four patients presenting cholesteatoma of the middle ear were involved in a retrospective study. Tympanoplasties were performed by the same surgeon over a 30-month period. The patients underwent ossiculoplasty with the shortest nondivisible partial titanium Spiggle & Theis prosthesis. Twenty-eight procedures were canal wall-up tympanoplasties and 17 were canal wall-down procedures; 27 were primary tympanoplasties and 18 were revisions. Audiometric data were evaluated before and after surgery, with a mean follow-up of 13.4 months.

RESULTS: Improvement of the air-bone gap was 6+/-12.2dB. The overall success rate was 56% and 67% using the Glasgow Benefit Plot and a postoperative air-bone gap lower than 20dB, respectively. There was no significant functional difference between canal wall-up and canal wall-down procedures. Hearing results were better in primary tympanoplasties than in revisions (p=0.004). The extrusion rate was 2.2%.

CONCLUSION: The functional results observed in this study confirm that this partial titanium Spiggle & Theis prosthesis is a valuable biomaterial for ossicular reconstruction in primary tympanoplasty for cholesteatoma.

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