Ossiculoplasty in Intact Stapes and Malleus Patients: A Comparison of PORPs Versus TORPs With Malleus Relocation and Silastic Banding Techniques

Objectives: To compare hearing results in patients undergoing ossiculoplasty using either partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP) with Silastic banding and malleus relocation techniques in cases with malleus and stapes both present and mobile. Study Design: Prospective nonrandomized clinical study. Setting: Tertiary referral center. Methods: Five hundred eighty-five patients undergoing ossiculoplasty were enrolled in this study from April 1991 to May 2010. Comparative analyses were made between a group of 304 patients who underwent ossiculoplasty with partial prosthesis positioned from the malleus to the stapes head and 281 patients who underwent ossiculoplasty with total prosthesis positioned from the malleus to the stapes footplate. Preoperative and postoperative audiometric evaluation using conventional audiometry, that is, air-bone gap (ABG), bone-conduction thresholds, and air-conduction thresholds were assessed. Results: In the PORP group, the mean postoperative ABG was 13.1 dB compared with 8.9 dB in the TORP group, (95% confidence interval [CI], 2.2-6.2 dB; p Conclusion: In patients with an absent incus and intact stapes and malleus, ossicular reconstruction with TORP combined with our malleus relocation and Silastic banding technique results in significantly better hearing outcomes compared with reconstructions with PORP