Functional results in ossiculoplasty with different titanium prostheses

BackgroundTitanium prostheses provide functionally promising results after reconstruction. Additional designs are created to improve and facilitate the surgical technique.ObjectivesTo compare the functional results in patients receiving classic and Vario® titanium prostheses for ossicular reconstruction and to document the amount of time required to prepare both prostheses.Study designProspective randomized comparative study.Patients and methods16 Patients underwent ossiculoplasty. The first group received the classical titanium prosthesis (n = 8), and the second group received the Vario® titanium prosthesis (n = 8). Three patients underwent primary ossicular reconstruction after trauma and 13 underwent second stage reconstruction after tympanoplasty.ResultsAudiological assessment at 12 months revealed a significant improvement (p < 0.0001) in air-bone gap (ABG), in each group separately, with an average improvement by 21 dB in the classical, and 25 dB in the Vario® titanium groups. However, there was no significant difference in improvement of the ABG between both groups. Closure of the average postoperative air bone gap within 20 dB or less was considered a successful hearing result and this was achieved in 83% (10/12) of cases in the classical group, 75% (6/8) of cases in the Vario® group and in 80% (16/20) in both groups.ConclusionOssiculoplasty using either the classic or Vario titanium prosthesis showed a significant improvement in hearing. The classical titanium prothesis is preferred over the adjustable Vario® type as the latter proves to be time consuming for intraoperative shaping and trimming rendering it to be not cost effective.