Since cholesteatomas are locally invasive, producing serious complications by erosion of the temporal bone, the primary goal of therapy remains permanent eradication of the disease. Most vulnerable are the middle ear ossicles and an attempt to
restore
hearing acuity is made by ossicular reconstruction. Autogenous ossicles have always been the best material for the reconstruction in our hands, but they are not readily available and not advisable to use it, especially in cases of extensive
cholesteatoma.
The present study reports the results of 83 ossiculoplasties for aural cholesteatomas, using alloplastic TORPs(38) and PORPs(45). The difference between pre-and post operative air-bone gap was 12dB in average. Of 38 TORPs 12 cases (31.5%) were
within
30dB of post-operative air-bone gap and the post-operative mean hearing gain was 10dB. Of 45 PORPs 16 cases(35.5%) were within 30dB of post-operative air-bone gap and the post-operative mean hearing gain was 15dB. The causes of reconstruction
failure
were recurrent cholesteatoma, extrusion of the alloplasts, and graft failure in the order of frequency.
The surgical management of cholesteatoma should be individualized for selecting the most appropriate operative procedure. Because of an unacceptable high extrusion rate and redicivism, it seems to be justified to look for further alternative
solutions
and to study the long-term postoperative results.
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