Synchronous Ossiculoplasty with Ossicular Replacement Prosthesis during Canal Wall Down Mastoidectomy

Objectives: To evaluate the anatomical and audiological out­ comes of synchronous ossiculoplasty with ossicular replace­ ment prosthesis during canal wall down mastoidectomy for advanced cholesteatoma. Methods: The prospective study was done at a tertiary referral institute included 30 patients of cholesteatoma who underwent canal wall down mastoidectomy. Ossicular reconstruction was performed using polytetrafluoroethylene (PTFE) (teflon) partial or total ossicular replacement prosthesis. Patients were assessed at 1st, 3rd and 6th postoperative months for graft uptake and hearing evaluation using pure tone audiometry (PTA) in which air bone gap (ABG) closure and mean ABG was calculated and compared with the mean preoperative ABG. Results: The mean ABG [both total occicular replacement prosthesis (TORP) and partial occicular replacement prosthesis (PORP) groups combined] considerably reduced from 34.33 ± 4.10 dB preoperatively to 15.47 ± 7.65 dB postoperatively at 6 months. There was a 46.29% of closure of ABG in 1st month, which closed more (53.89%) in 3rd month and even more (55.34%) in 6th postoperative month. p < 0.001 showed the ABG closure ratio and reduction in the mean ABG was statistically significant in the postoperative period. Conclusion: Ossicular reconstruction with ossicular replace­ ment prosthesis offers good functional results when performed during canal wall down surgery for advanced cholesteatoma, as a single­stage procedure.