Hearing results after ossiculoplasty with incus transposition, cortical bone autografting and bone cement

Background: This study assesses hearing results after ossiculoplasty with incus transposition (IT), cortical bone autograft (CBA) and bone cement (BC). Methods: A total of 21 patients with mild/moderate conductive hearing loss were enrolled in our study. Patients were assigned to each of the three techniques according to length of incus defect. Pre-operative and 6 months post-operative audiograms (PTA) were obtained and results of air bone gap (ABG) were statistically analyzed. Results: A total of 7 patients were included in each technique. BC ABG was decreased from 26.57 (5.06) (mean (SD)) to 10.86 (6.34) with mean gain 15.71 (5.85) For IT group, the mean for pre- ABG was 33.57 with SD 5.13, it became 15.86 (1.86) after 6 months of follow-up with 17.71 (3.40) gain. For CBA, pre- ABG mean was 35.86 (5.67) that finally became 19.14 (2.41) achieving ABG gain 16.71 (6.68). No significant statistical difference between pre-post gain in all three surgical procedures (p-value = 0.80). Regarding side effects in each technique, infections was noted in one case of IT and two cases of CBA, transient infection was found in one case of IT and CBA, and transient vertigo in one case of BC with no significant difference in adverse effects between the three group (P-value= 0.494). Conclusions: Both BC, IT and CBA are reliable techniques for ossiculoplasty with good postoperative hearing results. The choice of the proper technique depends on length of incus defects.