Prospective Study of Audiological Analysis of Ossiculoplasty in Cases of Chronic Suppurative Otitis Media


  • Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Department of ENT, Nashik, Maharashtra, 422003, India


Background: Ossiculoplasty is defined as reconstruction of the ossicular chain using various graft materials and techniques. Aim: Audiological analysis with Pure Tone Audiometry (PTA) of results of ossiculoplasty in cases of safe and unsafe csom and its correlation with preoperative middle ear status using Kartush’s Middle Ear Risk Index (MERI). Methodology: Non randomized prospective study conducted over 2 years in 34 patients with CHL; ossiculoplasty conducted with cartilage, remodeled autologous incus or malleus, malleostapediopexy and PORP; preoperative and 3 months postoperative PTA done. Kartush’s MERI to correlate preoperative middle ear status with postoperative hearing results done. Out of 34 patients operated: 10-cartilage ossiculoplasty, 6-autologous incus, 2-autologous malleus, 4-PORP and 12-malleostapediopexy. Results and Conclusion: Hearing improvement was seen in all types of osssiculoplasties using various materials and techniques. However, there was no significant statistical difference between the various types in relation to the postoperative hearing improvement. Kartush’s MERI was found to be an indicator of postoperative hearing improvement. It was found that as the value of the index increases, the postoperative hearing improvement decreases.


Chronic Suppurative Otitis Media (CSOM), Middle Ear Risk Index (MERI), Ossiculoplasty, Pure Tone Audiometry

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Gajjar Y, Aiyer R, Gajjar YK, Umarwada S. Use of a Remodeled Autologous Incus as an Ossicular Prosthesis, World Articles in Ear, Nose and Throat. 2010; (3-1).

Chavan SS, Jain PV, Vedi JN, kumar Rai D, Kadri H. Ossiculoplasty: A prospective study of 80 cases, Iranian Journal of Otorhinolaryngology. 2014 Jul; 26(76):143−50.

Mahanty S, Maiti AB, Naskar S, Das SK, Mandal S, Karmakar M. A comparative study of outcome of ossiculoplasty using cartilage graft, bone and different alloplasts in chronic otitis media, Indian J. Otol. 2015; 21:144−48.

Kartush JM. Ossicular chain reconstruction. Capitulum to malleus, Otolaryngologic Clinics of North America. 1994; 27(4):689−715.

Mokhtarinejad F, Motasaddi M, Barzegar F, Poorqasemiyan M. Ossiculoplasty with Sculpted Incus: Hearing Results and Risk Factors, Journal of Hearing Sciences and Otolaryngology. 2015; 1(2):29−35.

Kumar S, Yadav K, Ojha T, Sharma A, Singhal A, Gakhar S. To Evaluate and Compare the Result of Ossiculoplasty Using Different Types of Graft Materials and Prosthesis in Cases of Ossicular Discontinuity in Chronic Suppurative Otitis Media Cases, Indian Journal of Otolaryngology and Head and Neck Surgery. 2017; 1−7. PMid: 29456937, PMCid: PMC5807288.

Vartiainen E, Nuutinen J. Long-term hearing results of one-stage tympanoplasty for chronic otitis media, Eur. Arch. Otorhinolaryngol. 1992; 249(6):329−31. PMid:1418943.

O’Reilly RC, Cass SP, Hirsch BE, Kamerer DB, Bernat RA, Poznanovic SP. Ossiculoplasty using incus interposition: Hearing results and analysis of the middle ear risk index, Otol. Neurotol. 2005 Sep; 26(5):853−58.

e Corso E, Marchese MR, Sergi B, Rigante M, Paludetti G. Role of ossiculoplasty in canal wall down tympanoplasty for middle-ear cholesteatoma: Hearing results, The Journal of Laryngology and Otology. 2007 Apr; 121(4):324−28. https:// PMid: 17125581.

Mahadevaiah A, Parikh B. Use of autogenic and allogenic malleus in tympanic membrane to footplate assembly-long-term results, Indian Journal of Otolaryngology and Head and Neck Surgery. 2009 Mar 1; 61(1):9−13. s12070-009-0025-5. PMid: 23120595, PMCid: PMC3450125.

Quérat C, Martin C, Prades JM, Richard C. Canal wall up tympanoplasty for cholesteatoma with intact stapes: comparison of hearing results between cartilage and PORP on stapes and impact of malleus removal and total reinforcement of the tympanic membrane by cartilage, Eur. Ann. Otorhinolaryngol Head Neck Dis. 2014; 131(4):211−16. PMid: 24954899.

Guidelines of the Committee on Hearing and Equilibrium. Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss, Otolaryngol Head Neck Surg 1995; 106:865−67.

Sharma K, Gururani P, Arora A, Singh G. Role of Autologous Versus Homologous Cartilage in Ossicular Reconstruction: A Comparative Study, Indian Journal of Otolaryngology and Head and Neck Surgery. 2017 Jun 1; 69(2):137−41. PMid: 28607880, PMCid: PMC5446330.

Harvey SA, Lin SY. Double cartilage block Ossiculoplasty in chronic ear surgery, Laryngoscope. 1999; 109(6):911−14. PMid: 10369281.

Yuge K, Daito K, Nakamura K, Nakamura K, Murakami M, Hattori Y, Murakami T, Mozume S. Results of malleostapediopexy, Auris Nasus Larynx. 1983 Jan 1; 9(3):145−50.

Felek SA, Celik H, Islam A, Elhan AH, Demirci M, Samim E. Type 2 ossiculoplasty: Prognostic determination of hearing results by middle ear risk index, American Journal of Otolaryngology. 2010 Oct 31; 31(5):325−31. PMid: 20015772.


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