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- Title
Reconstruction of hearing when malleus is absent: Torp vs. Homograft tmmi.
- Authors
Lesinski, S. George
- Abstract
To study the most appropriate ossicular reconstruction of patients with an absent malleus, a comparison was made utilizing a homograft tympanic membrane with attached malleus and shaped incus (TMMI) columella and the alternative use of underlay fascia tympanoplasty with a cartilage covered TORP. Forty-six patients were reconstructed with a homograft TMMI and 38 with cartilage covered TORP and underlay fascia technique; 4.5 years postoperatively, 84% of those patients reconstructed with a homograft TMMI maintained an average A/B gap of 25 dB or better. Though 1 year postoperatively the TORP hearing results were satisfactory, only 18% of the TORP patients maintained a hearing level within 25 dB A/B gap at 4 years postoperatively. Primary causes of failure of the TORP were instability with migration off the stapes footplate, protrusion or extrusion through the TM and finally, long-term softening and bending secondary to biodegradation of the Plastipore®. The discouraging long-term hearing results found in the TORP patients in this study confirm similar findings reported in 1982 by Smyth in a 5 year follow-up on. 116 TORP patients.
- Publication
Laryngoscope, 1984, Vol 94, Issue 11, p1443
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1288/00005537-198411000-00008