EFFECT OF THE PRESENCE OF EXTERNAL EAR CANAL WALL ON FUNCTIONAL OUTCOMES OF OSSICULAR RECONSTRUCTION WITH TITANIUM TOTAL OSSICULAR REPLACEMENT PROSTHESIS (TORP)

Methods: Patients who underwent middle ear surgery and ossicular reconstruction with TORP in a tertiary referral center between 2009-2014 were retrospectively searched in two groups; Canal Wall Up (CWU) + TORP and Canal Wall Down (CWD) + TORP. Functional results were evaluated.

Results: A total number of 89 cases were evaluated. CWU group included 25, CWD group included 36 patients who met inclusion criteria. In the CWU group, the mean pre-operative pure tone average (PTA) value was 58.1±11.2 dB; postoperative PTA was 44.1±17.9 dB, the mean increase was 13.9±14.3 dB. In the CWD group, the mean preoperative PTA was 56.6 ±15.3 dB, postoperative PTA was 50.6±21.3 dB, the mean increase was 6.0±15.6 dB. The mean air-bone gap (ABG) closure value was 14.4±11.5 dB in the CWU group and 6.4±10.5 dB in the CWD group. There was a significant difference in terms of PTA increase and ABG closure values between the two groups.

Conclusions: The external ear canal wall has a positive effect on postoperative hearing when an ossiculoplasty with Titanium TORP is performed. The removal of ECW leads to a hearing loss of about 9dB in PTA levels and 8dB in ABG closure values in these cases. Keywords : Ossicular prosthesis; titanium; ear canal; hearing