{Reference Type}: Journal Article
{Title}: Exclusive endoscopic management of incus long process major defects: conventional incus interposition versus malleostapediopexy.
{Author}: Gülşen S;Çikrikci S;
{Journal}: Eur Arch Otorhinolaryngol
{Volume}: 281
{Issue}: 8
{Year}: 2024 Aug 1
{Factor}: 3.236
{DOI}: 10.1007/s00405-024-08541-z
{Abstract}: OBJECTIVE: The aim of the current study is to compare the surgical and audiometric results of conventional incus interposition (IP) versus malleostapediopexy (MS) in incus long process large defects.
METHODS: A total of 71 patients (incus IP group n = 37, MS group n = 34) were enrolled in this study. All patients enrolled in the current study underwent ossiculoplasty via an exclusive endoscopic transcanal approach. Pre- and postoperative audiometric measurements and air-bone gap (ABG) values were compared, and if the postoperative ABG value was less than 20 dB, ossiculoplasty was considered successful. Graft success rates and complications were also compared.
RESULTS: The average auditory gain was 14.7 ± 4.2 dB in the incus IP group and 18.3 ± 5.1 dB in the MS group. The auditory gain was significantly greater in the MS group relative to the incus IP group (p = 0.012). Ossiculoplasty success (postoperative ABG value < 20 dB) rate was 70.3% in the incus IP group patients and 88.2% in the MS group patients (p < 0.001). There was no significant difference in terms of graft success rate between groups (p > 0.05) and the overall graft uptake rate was 91.5% (65/71).
CONCLUSIONS: Malleostapediopexy-bridging of malleus and stapes using bone cement-is an effective, reasonable, and more efficient technique in terms of auditory outcomes relative to the conventional incus interposition in endoscopic transcanal management of incus long process major defects.