Cost Effective Ossicular Reconstruction- A Case Report
Life Sciences-Medicine
DOI:
https://doi.org/10.22376/ijpbs/lpr.2022.12.5.L18-22Keywords:
Prosthesis, Grommet, Ossicles, ossicular chain, mastoid air cell systemAbstract
Ossicular reconstruction using various materials from autograft to artificial prosthesis have a wide range of success and failure rates due to various reasons. In this article, a newer use of old grommet in ossicular reconstruction is attempted. A 50yr old lady presented with hearing loss in the right ear for one year. She gave a previous history of ear discharge 11 months back. There was no other positive history relevant to the case. On examination, the pars tensa was plastered and immobile on the left side. Her Pure tone audiometry showed conductive hearing loss on the left ear with average 55 db loss. Her CT showed absent incus with obliteration of middle ear-space and sclerosed mastoid. We planned for Tympanotomy. On elevating the flap, the incus and stapes were absent. Here we decided on a newer use for the grommet and used it as prosthesis. The result is good and promising with no complications. The grommet did not get extruded or produce granulation tissue. The ear is dry and the patient is still on follow up. The purpose of publishing this report is to identify a prosthesis that is cost-effective and readily available. The grommet has been used for a more extended period for other indications,but as a prosthesis for reconstruction is a new method and requires further studies.
References
Aristides sismanis A. Tympanoplasty. In: Glasscock-Shambaugh surgery of the ear. 5th ed. p. 463-85.
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;26(5):853-8. doi: 10.1097/01.mao.0000185054.92265.b7, PMID 16151328.
Hall A, Rytzner C. Stapedectomy and autotransplantation of ossicles. Acta Otolaryngol. 1957;47(4):318-24. doi: 10.3109/00016485709130348, PMID 13424240.
Wehrs RE. Results of homografts in middle ear surgery. Laryngoscope. 1978;88(5):808-15. doi: 10.1002/lary.1978.88.5.808, PMID 642674.
Wehrs RE. Incus replacement prostheses of hydroxylapatite in middle ear reconstruction. Am J Otol. 1989;10(3):181-2. doi: 10.1016/0196-0709(89)90060-4, PMID 2546430.
Macias JD, Glasscock ME, Widick MH, Schall DG, Haynes DS, Josey AF. Ossiculoplasty using the black hydroxylapatite hybrid ossicular replacement prostheses. Am J Otol. 1995;16(6):718-21. PMID 8572132.
Swain RE. Beale B. HAPEX: a bioactive hydroxylapatite/polyethylene composite suitable for otologic applications Bartlett, TN: Smith & Nephew ENT, 1995. P. 2123.
Swain RE, Beale B. HyCor 200: a coralline hydroxylapatite biomaterial used in ossicular replacement surgery Bartlett, TN: Smith & Nephew ENT; 1996.
Jahn AF. Experimental applications of porous (coralline) hydroxylapatite in middle ear and mastoid reconstruction. Laryngoscope. 1992;102(3):289-99. doi: 10.1288/00005537-199203000-00011, PMID 1312190.
Martin AD, Harner SG. Ossicular reconstruction with titanium prosthesis. Laryngoscope. 2004;114(1):61-4. doi: 10.1097/00005537-200401000-00010, PMID 14709996.
Gardner EK, Jackson CG, Kaylie DM. Results with titanium ossicular reconstruction prostheses. Laryngoscope. 2004;114(1):65-70. doi: 10.1097/00005537-200401000-00011, PMID 14709997.
Luetje CM, Denninghoff JS. Perichondrial attached double cartilage block: a better alternative to the PORP. Laryngoscope. 1987;97(9):1106-8. doi: 10.1288/00005537-198709000-00020, PMID 3626739.
Vincent R, Oates J, Sperling NM, Annamalai S. Malleus relocation in ossicular reconstruction: managing the anteriorly positioned malleus: results in a series of 268 cases. Otol Neurotol. 2004;25(3):223-30. doi: 10.1097/00129492-200405000-00004, PMID 15129096.
Vincent R, Sperling NM, Oates J, Osborne J. Ossiculoplasty with intact stapes and absent malleus: the silastic banding technique. Otol Neurotol. 2005;26(5):846-52. doi: 10.1097/01.mao.0000185068.50575.92, PMID 16151327.
Yung M. Long-term results of ossiculoplasty: reasons for surgical failure. Otol Neurotol. 2006;27(1):20-6. doi: 10.1097/01.mao.0000176173.94764.f5, PMID 16371842.
Sara N, Neelathahalli Kasturirangan M. Prevalence of Off-label Drug Use in Neonatal Intensive Care Unit of a Tertiary Care Teaching Hospital in India. Int J Pharma Bio Sci;11(3). doi: 10.22376/ijpbs.2020.11.3.p18-23.
Yadav K, Lokhande S, pitale s. janwadkar,p.s. navarkar and p.k. rana. IJBPS; 3. Solvent extraction and spectrophotometric determination of mo (vi) by using acetophenone 2’,4’-dihydroxy semicarbazone as an analytical reagent d;4:309-14.
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