1. Analysis of Results Dr.Jerry Halik MD FRCSC
OSSICULOPLASTY
Analysis of Results
Dr.Jerry Halik MD FRCSC

2. N= (Total-209)
Age 5-71
Follow-up: up to 71 months(2 years average)

5. Applebaum Incus Replacement Prosthesis(small)
Average age: 41 years (18-67)
Average follow-up: 20 months(1-76)

6. Applebaum Incus Replacement Prosthesis(small)- Pre-op Diagnosis
Chronic Otitis Media : 25(89%)
Cholesteatoma : 2
Trauma : 1

7. Applebaum Incus Replacement Prosthesis(small)-Types of Repair
Ossiculoplasty:12(43%)
Ossiculoplasty with Tympanoplasty :14(50%)
With canal wall down Mastoidectomy and Tympanoplasty:2 (7%)

8. Applebaum Incus Replacement Prosthesis(small)-Results A-B closure Possible SRT<30 db:23 post op SRT <30dB:15/23(65%)
0.5,1,2kHz
0.5,1,2,4kHz
< 10dB
11/28
(39%)
9/28
(32%)
<20dB
10/28
(36%)
Total
22/28
(78%)
19/28
(68%)

10. Wehr’s 2.7mm Incus Replacement Prosthesis
Average age:40 years(12-67)
Average follow-up:19 months(1-77)

11. Wehr’s 2.7mm Incus Replacement Prosthesis-Pre-op Diagnosis
Chronic Otitis Media: 15 (52%)
Cholesteatoma: 9 (31%)
Malleus Head Fixation : 5(17%)

12. Wehr’s 2.7mm Incus Replacement Prosthesis- Types of Repair
Ossiculoplasty:12 (41%)
Ossiculoplasty with Tympanoplasty: 10(34%)
With canal wall down Mastoidectomy and Tympanoplasty: 7(24%)

13. Wehr’s 2.7mm Incus Replacement Prosthesis-Results possible SRT<30db: Post op SRT< 30dB:13/25(52%) A-B Closure
0.5,1,2kHz
0.5,1,2,4kHz
<10dB
10/29 (34%)
9/29(31%)
<20dB
11/29(38%)
12/29(41%)
Total
21/29(72%)

14. Wehr’s 2.7mm Incus Replacement Prosthesis-Complications
Hearing worse: 3 (10%)
Hyperacusis: 1 (3%)

15. Wehr’s mm Incus-Stapes Replacement Prosthesis
Average age:34 years (5-67)
Average follow-up : 25 months(1-66)

17. Wehr’s Incus-Stapes Replacement Prosthesis- Pre-op Diagnosis
Chronic Otitis Media : 16 (44%)
Cholesteatoma: 18 (50%)
Congenital malformation:2

18. Wehr’s 2.7mm Incus-Stapes Replacement Prosthesis-Type of repair
Ossiculoplasty: 11(31%)
Ossiculoplasty with Tympanoplasty:13(36%)
With canal wall down Mastoidectomy and Tympanoplasty : 12(33%)

19. Wehr’s Incus-Stapes Replacement Prosthesis Results possible SRT<30db: Post op SRT< 30dB:19/32(59%) A-B Gap Closure * 1 overclosure
0.5,1,2kHz
0.5,1,2,4kHz
<10dB
16/36(44%)
11/36(31%)
<20dB
10/36(28%)
12/36(33%)
Total
26/36(72%)
23/36(64%)

20. Wehr’s 2.7mm Incus-Stapes Replacement Prosthesis-Complications
Hearing worse: 1
Extrusion: 1 (4 years)
Dislocation: 1

21. Malleus-Stapes Assembly
N=26
Average age : 37 years (12-71)
Average follow-up:22 months(1-63)

23. Malleus-Stapes Assembly-Pre-op Diagnosis
Chronic Otitis Media: 16 (62%)
Cholesteatoma:6 (23%)
Trauma: 1
Malleus Head Fixation: 3

24. Malleus-Stapes Assembly-Types of Repair
Ossiculoplasty: 12(46%)
Ossiculoplasty with Tympanoplasty:10(38%)
With canal wall down Mastoidectomy and Tympanoplasty: 4

25. Malleus-Stapes Assembly-Results A-B gap closure Possible SRT<30dB :22 Post-op SRt<30dB: 11/22 (50%)
0.5,1,2kHz
0.5,1,2,4kHz
<10dB
3/26(12%)
2/26(8%)
<20dB
8/26(31%)
10/26(38%)
Total
11/26(42%)
12/26(46%)

26. Malleus-Stapes Assembly-Complications
Worse Hearing: 5(19%)

27. Assemblies- Total (N=119)
Pre-op diagnosis
Chronic Otitis Media: 72(61%)
Cholesteatoma:35(29%)
Trauma:2
Malleus Head Fixation:8
Congenital:2

28. Assemblies-Types of repair
Ossiculoplasty: 47 (39%)
Ossiculoplasty with Tympanoplasty:47(39%)
Ossicuplasty withTympanoplasty and canal wall down Mastoidectomy: 25(21%)

29. Assemblies-Results A-B gap closure possible SRT<30dB: Post op<30dB:58/102(57%) * 1 overclosure
0.5,1,2kHz
0.5,1,2,4kHz
<10dB
40/119(34%)
31/119(76%)
<20dB
44/119(37%)
Total
80/119(68%)
75/119(63%)

30. Assemblies-Complications
Hearing worse: 8(7%)
Hyperacusis: 1
Extrusions: 1
Dislocation: 1

31. Torps and Porps N=14 Average age:40 years.(4-65)
Average follow-up:21 months(6-49)

32. Torps and Porps- Pre-op Diagnosis
Chronic otitis media:8(57%)
Cholesteatoma: 4(29%)
Congenital malformation: 1
Malleus head fixation:1

33. Torps and Porps- Types of Repair
Ossiculoplasty:2
Ossiculoplasty with Tympanoplasty:11(79%)
With canal wall down Mastoidectomy and Tympanoplasty : 1

34. Torps and Porps- Results A-B gap closure possible Sat<30dB:12 Post op Sat<30dB:4/12(25%)
0.5,1,2kHz
0.5,1,2,4kHz
<10dB
2/14(14%)
1/14(7%)
<20dB
6/14(43%)
5/14(36%)
Total
8/14(57%)

35. Torps and Porps: Complications
Extrusion:1(7%)

36. Conclusions
Assemblies better than torp’s and porp’s(60% vs 25% success)
?Effectiveness of malleus-stapes assembly
?which prosthesis
Safe
Long term results problematic
Single stage procedures reasonable
?Cost effective
?Use of aids after failure