Is bone cement a cost-effective solution?
Review by Sangeeta Maini and Bhaskar Ram

This study looks at the functional results of 52 patients who underwent bone cement ossiculoplasty. Patients were divided into four groups based on ossicular disruption. Group 1 (30 patients) had lenticular erosion only. Group 2 (13 patients) had absent incus. Group 3 (five patients) were the same as Group 1 with fixation of stapes footplate and Group 4 (4 patients) had incudo-malleolar discontinuity. Glass ionomer cement was used for reconstruction. Patients underwent ‘incus to stapes reconstruction’ (Group 1), ‘malleus to stapes reconstruction’ (Group 2), ‘incus to stapes reconstruction plus stapedotomy’ (Group 3) and ‘malleus to incus reconstruction’ (Group 4). Preoperative and postoperative audiological findings of each group were evaluated at 0.5, 1, 2 and 4 khz. Closure of postoperative ABG of patients to less than 20db and 10db were as follows: 70% and 43% in Group 1; 86% and 76% in Group 2; 100% and 60% in Group 3; and 75% and 50% in Group 4, respectively. The success rates seemed good with comparable benefit to other standard techniques and the main benefit was the very low cost in comparison with other prosthesis. It was interesting to note that in this study, Group 2 patients achieved better results when compared to Group 1. Twenty-one percent of the cases were revisions (either for recurrent cholesteatoma, persistent perforation or failed ossiculoplasty). The numbers were small in Group 3 and Group 4. Follow-up ranged from 14-32 months in the four groups studied. It would be interesting to see the long-term results of these patients.

Comparison of various bone cement ossiculoplasty techniques and functional results.
Gungora V, Atay G, Bajinb MD et al.
ACTA OTO-LARYNGOLOGICA
2016;136(9):883-7.