Background and Objectives: The goals in the surgery of chronic otitis media are to gain control of infection, closure of the tympanic membrane defects and hearing rehabilitation via ossicular chain reconstruction. Polymaleinate ionomeric cement, which has been used in dentistry as a filling and lute material for more than 15 years, has recently been used to construct total and partial ossicular prostheses. We intended to evaluate the hearing results of ossicular chain reconstruction using polymaleinate ionomeric prosthesis (IONOS®) in patients with chronic otitis media with the minimum 3 years postoperative follow-up periods.
Materials and Method: Forty-four cases (30 PORP and 14 TORP), who underwent ossicular chain reconstruction using IONOS® in the Chonnam University Hospital from 1993 to 1996, were reviewed retrospectively. A postoperative hearing was accessed by the postoperative air-bone gap (ABG). Postoperative ABG was divided into the following three groups, ABG of≤20 dB, ABG of 21-30 dB and ABG of ≥31 dB.
Results: In the 44 total cases, 14 cases (31.8)had≤20 dB ABG and 21 cases (47.7%)had≤30 dB ABG. In the 20 PORP cases, 13 (43.3%) had≤20 dB ABG and none had between 21-30 dB ABG. On the other hand, in the 14 TORP cases, only one case (7.1%) had≤20 dB ABG and 7 cases (50.0%) had between the 21-30 dB ABG. These data showed that most of hearing improvement were achieved below 20 dB ABG in the PORP cases and between 21-30 dB ABG in the TORP cases. When the successful hearing gain was defined as less than 20 dB ABG, the good middle ear mucosal status, the patent preoperative Valsalva maneuver and the intact canal wall tympanomastoidectomy showed significantly better long-term hearing results of ossiculoplasty with the IONOS® PORP.
Conclusion: The results of this study suggest that IONOS® is not the ultimate solution in ossiculoplasty and efforts should be given to search for more suitable materials in ossiculoplasty to achieve better hearing results.
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