Comparison of the Hearing Results of Total Ossicular Chain Autogenous Mastoid Cortical Bone Ossiculoplasty and Titanium Total Ossicular Replacement Prosthesis in Patients with Cholesteatoma

Background: No studies have investigated the results of ossicular chain reconstruction using mastoid cortical bone ossiculoplasty (MCBO) and titanium total ossicular replacement prosthesis (TiTORP) in Austin-Kartush Group D cholesteatoma patients with severe middle ear risk index (MERI). Objectives: The present study aimed to compare the hearing results of MCBO and TiTORP in Austin-Kartush Group D cholesteatoma patients with severe MERI who underwent ossicular chain reconstruction during primary surgery. Methods: The hearing results of 28 adult cholesteatoma patients who underwent tympanomastoidectomy and ossicular chain reconstruction with MCBO (n=15) or TiTORP (n=13) were analyzed in the current study. The postoperative hearing was tested 12 months after the surgery.  The hearing-related functional success rate was determined in accordance with the American Academy of Otolaryngology-Head and Neck Surgery Foundation criteria. Results: When all patients were taken into account, the mean preoperative and postoperative air-bone gaps (ABG) were reported as 32.2 decibel (dB) and 17.6 dB, respectively, (P<0.001). In 57.1% of the patients, the mean postoperative ABG was ≤ 20 dB. The mean preoperative and postoperative ABGs of the MCBO group were obtained at 29.9 and 16.2 dB, while these values were reported as  35.0 and 19.3 dB in the TiTORP group (P=0.001 and P<0.001, respectively). Hearing-related functional success rates were calculated at 60.0% and 53.8% in MCBO and TiTORP groups, respectively, without any significant difference between the groups (P= 0.743). Conclusion: As evidenced by the obtained results, MCBO and TiTORP can provide similar and successful hearing results in Austin-Kartush Group D patients with cholesteatoma; nonetheless, MCBO is a more cost-effective option in this regard.