Comparison of the Ionomeric Bone Cement and incus Interposition in Reconstruction of Ossicular Chain

Yıl 2014, Cilt: 4 Sayı: 3, 151 - 156, 18.01.2015

Rauf Kum Müge Özcan Tuğçe Gülseven Nurcan Yurtsever Kum Yavuz Yılmaz Ali Titiz Adnan Ünal

https://doi.org/10.16899/ctd.58426

Cited By: 1

Öz

Objective: In this study, we aimed to compare the success of glass ionomer cement application (GIC) and incus interpositioning technique in terms of hearing results and graft take rates.

Methods: This retrospective study performed on 53 patients who had surgery for chronic otitis media. All patients had an incus long process defect and a normal stapes superstructure. Ossicular reconstruction was performed using incus interposition technique in 31 patients (group 1), while GIC was performed in other 22 patients (group 2). The age, sex, success rate of graft take and hearing results were compared between the groups.

Results: In both groups, there was a statistical significant improvement in terms of the mean air conductance threshold and decrease in the mean air-bone gap (ABG) (p=0.001; p<0.001) The comparison of the mean ABG changes in terms of success,  between incus interposition and GIC groups showed no statistically significant difference (p>0,05).

Conclusion: Both GIC application and incus interpositioning technique are effective methods in reconstructing incus long bone defects and they are not superior to each other.

Anahtar Kelimeler

Glass ionomer cement; Incus interposition; Ossiculoplasty.

Kemikçik Zincir Onarımında İyonomerik Kemik Çimentosu ve İnkus İnterpozisyonun Karşılaştırılması

Öz

 Amaç:Çalışmamızda inkus uzun kolu defektlerinin onarımında iyonomerik kemik çimentosu  (İKÇ) ve inkus interpozisyon (İİ) kullanılan hastaları, işitme sonuçları ve greft başarısı açısından karşılaştırmayı amaçladık.

Yöntem: Bu retrospektif çalışmaya kemik zincir de stapes suprastrukturu normal olup inkus uzun kolu defektif olan ve kemikçik zincir rekonstrüksiyonu yapılan 53 hasta dahil edildi. Hastalar kemikçik zincir onarım tekniğine göre, İİ kullanılanlar (Grup 1) ve İKÇ kullanılanlar (Grup 2) olarak iki gruba ayrıldı. Gruplar yaş, cinsiyet, greft başarı oranı, hava saf ses eşikleri değerleri ve hava-kemik aralığı (HKA) açısından karşılaştırıldı.

Bulgular: Her iki grup da operasyon sonrası hava saf ses eşiklerindeki ve preoperatif döneme göre postoperatif HKA değerlerindeki düzelme istatiksel olarak ileri derecede anlamlıydı (p=0.001; p<0,01). Gruplar arasında HKA değerlerinin fonksiyonel olarak başarılı olarak kabul edilmesine göre istatistiksel olarak anlamlı farklılık saptanmamıştır (p>0,05).

Sonuç:İnkus uzun kolu defekti olan hastalarda kemikçik zincir onarımı amacıyla kullanılan İKÇ ve İİ etkili yöntemlerdir ve birbiri üzerine belirgin bir üstünlükleri yoktur.

 

Anahtar Kelimeler

İnkus interpozisyonu; İyonomerize Kemik Çimento; Ossikuloplasti

Kaynakça

• Goebel JA and Jacob A. Use of Mimix hydroxyapatite bone cement for difficult ossicular reconstruction. Otolaryngol Head Neck Surg 2005;132:727-34.
• Huttenbrink KB and Lindorfer HW. [Teeth as prostheses materials for reconstruction of disrupted ossicular chain]. Hno 1993;41:440-5.
• Ozer E, Bayazit YA, Kanlikama M, et al. Incudostapedial rebridging ossiculoplasty with bone cement. Otol Neurotol 2002;23:643-6.
• Kveton JF and Coelho DH. Hydroxyapatite cement in temporal bone surgery: a 10 year experience. Laryngoscope 2004;114:33-7.
• Dere H, Ozdogan F, Ozcan KM, et al. Comparison of glass ionomer cement and incus interposition in reconstruction of incus long process defects. Eur Arch Otorhinolaryngol 2011;268:1565-8.
• Hall A and Rytzner C. Stapedectomy and autotransplantation of ossicles. Acta Otolaryngol 1957;47:318-24.
• Yazici H, Uzunkulaoglu H, Emir HK, et al. Comparison of incus interpositioning technique versus glass ionomer cement application in type 2 tympanoplasty. Eur Arch Otorhinolaryngol 2013;270:1593-6.
• Babu S and Seidman MD. Ossicular reconstruction using bone cement. Otol Neurotol 2004;25:98-101.
• Bayazit YA, Ozer E, Kanlikama M, et al. Bone cement ossiculoplasty: incus to stapes versus malleus to stapes cement bridge. Otol Neurotol 2005;26:364-7.
• Montelaro JS and Horn KL. Techniques and materials in ossicular reconstruction. Current Opinion in Otolaryngology & Head and Neck Surgery 1994;2:382-86.
• Kurihara A, Toshima M, Yuasa R, et al. Bone destruction mechanisms in chronic otitis media with cholesteatoma: specific production by cholesteatoma tissue in culture of bone-resorbing activity attributable to interleukin-1 alpha. Ann Otol Rhinol Laryngol 1991;100:989-98.
• Van Rompaey V, Claes G, Somers T, et al. Erosion of the long process of the incus in revision stapes surgery: malleovestibular prosthesis or incus reconstruction with hydroxyapatite bone cement? Otol Neurotol 2011;32:914-8.
• Hafiz G. A more reliable method for incudostapedial rebridging ossiculoplasty: bone cement and wire. Adv Ther 2005;22:56-62.
• Martin AD and Harner SG. Ossicular reconstruction with titanium prosthesis. Laryngoscope 2004;114:61-4.
• O'Reilly RC, Cass SP, Hirsch BE, et al. Ossiculoplasty using incus interposition: hearing results and analysis of the middle ear risk index. Otol Neurotol 2005;26:853-8.
• Siddiq MA and East DM. Long-term hearing results of incus transposition. Clin Otolaryngol Allied Sci 2004;29:115-8.
• Kupperman D and Tange RA. Ionomeric cement in the human middle ear cavity: long-term results of 23 cases. Laryngoscope 2001;111:306-9.
• Celik H, Aslan Felek S, Islam A, et al. The impact of fixated glass ionomer cement and springy cortical bone incudostapedial joint reconstruction on hearing results. Acta Otolaryngol 2009;129:1368-73.