Cartilage versus partial ossicular replacement prosthesis in ossiculoplasty during cholesteatoma surgery

Objective This study aims at comparing cartilage ossiculoplasty by lever method with ossiculoplasty by partial ossicular replacement prosthesis during cholesteatoma surgery. Patients and Methods This is a prospective study that was conducted on 36 cases having cholesteatoma; they were randomly divided into two groups of 18 in each group. In the first group (cartilage group), ossiculoplasty was performed with cartilage. In the second group (prosthetic group), ossiculoplasty was performed by partial ossicular replacement prosthesis. In both groups, eradication of the cholesteatoma was performed first at the same sitting of the ossiculoplasty by canal wall down tympanomastoidectomy with reconstruction of the posterior meatal wall at the same sitting. Results Within the follow-up period (1 year at least), the total rate of reported complications was relatively, but not significant, higher in the prosthesis group (50%) in comparison with the cartilage group (27.7%). There was a significant postoperative improvement in the air-bone gap in both groups; however, there was no significant difference between the two groups regarding improvement of the air-bone gap either 6 or 12 months after surgery. Conclusion Cartilage ossiculoplasty by lever method is an easy procedure for using an autogenous material in ossiculoplasty with no reaction, no extrusion, and also with acceptable hearing outcome.