Incudostapedial rebridging ossiculoplasty with glass ionomer cement: a case report

Year 2007, Volume: 17 Issue: 3, 183 - 186, 23.05.2007

Utku Kubilay Ozan Seymen Sezen Mahmut Özkırış Süheyl Haytoğlu Şeref Ünver

Abstract

A 31-year-old woman presented with a complaint of hearing loss of a two-year history. Otoscopic examina- tion revealed a Central ear drum perforation without discharge. The air-bone gap was 35 dB at 0.5, 1, 2, and 3 kHz. Under general anesthesia, the patient undervvent tympanoplasty for chronic otitis media. At surgery, the ossicular Chain was intact except for dis- continuity by a 2-mm gap between the long process of the incus and the head of the stapes. The gap was reconstructed with the use of a fluoroplastic prosthe- sis. Myringoplasty was successful, but the patient complained of hearing loss at the end of six months.Transcanal posterior tympanotomy was performed under local anesthesia for decreased conductive hear­ ing. The prosthesis was stili in place, but was not con- ducting the movements of the malleus to the stapes. İt was removed and glass ionomer cement Ketac-Cem was applied for rebridging. The average air-bone gap measured in the postoperative sixth month was less than 10 dB.

Keywords

Bone cements, hearing loss, conductive, incus/ surgery, prosthesis implantation, stapes/surgery

İnkus-stapedius iletimi için cam ionomer çimento ile ossiküloplasti: Olgu sunumu

Abstract

Otuz bir yaşında kadın hasta, iki yıldır var olan işit- me kaybı nedeniyle başvurdu. Otoskopik muayene- de kulak zarında santral perforasyon vardı, ancak akıntı yoktu. Saf ses odyometrisinde 0.5, 1, 2 ve 3 kHz’lerde hava-kemik yolu açıklığı 35 dB idi. Has- taya kronik otitis media tanısıyla genel anestezi al- tında timpanoplasti ameliyatı yapıldı. Ameliyat sıra- sında inkusun uzun kolu ile stapes başı arasında 2 mm’lik kemikçik zincir devamsızlığı görüldü. İleti fluroplastik protez ile sağlandı. Altıncı ayda yapılan kontrolde underlay olarak konulan greftin intakt ol- duğu; fakat, işitme kaybının devam ettiği saptandı. Lokal anestezi altında transkanal olarak yeniden ameliyat edilen hastada fluroplastik protezin yerin- de olduğu; fakat, iletimi sağlamadığı görüldü. Pro- tez çıkarılarak bu kez cam ionomer çimento Ketac- Cem kullanılarak bağlantı yeniden sağlandı. Has- tanın ameliyat sonrası altıncı ayda ölçülen ortala- ma saf ses hava-kemik yolu açıklığı 10 dB’den azdı

Keywords

Kemik çimentosu, işitme kaybı, iletim, inkus/cerrahi, protez implantasyonu, stapes/cerrahi

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