Download PDF
CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(04): e697-e700
DOI: 10.1055/s-0042-1743276
Original Research

Reconstruction of the Long Process of the Incus by Use of Glass Ionomer Cement: Our Experience

Khaled Abd El Rahman Ali 
1   Department of Otolaryngology-Head and Neck Surgery, Sohag University, Sohag, Egypt
,
Maha Ahmed Ibrahim 
2   Department of Otolaryngology-Head and Neck Surgery, Audiology Unit, Sohag University, Sohag, Egypt
,
Mohammed Ahmed Hussien 
3   Department of Otolaryngology-Head and Neck Surgery, Assiut Al-Azhar University Hospital, Assiut, Egypt
,
Khaled Gamal Dahy 
1   Department of Otolaryngology-Head and Neck Surgery, Sohag University, Sohag, Egypt
› Author Affiliations Funding The present research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
› Further Information
   Permissions and Reprints

Abstract

Introduction Chronic suppurative otitis media is one of the most common causes of reversible conductive hearing loss which can lead to necrosis of the ossicles. The incus, especially its long process, is the most common ossicle affected.

Objectives The present study aims to assess the use of glass ionomer cement for the reconstruction of the long process of the incus.

Methods The present study was conducted on 27 patients with chronic suppurative otitis media with central perforation with dry and quiescent ears with an eroded long process of the incus submitted to tympanoplasty. The audiological evaluations were done on all patients, including preoperative and postoperative evaluation of the air-bone gap; the average pure tone threshold was done 6 months postoperatively.

Results The average air pure tone threshold was 42.8 dB preoperatively and 22.5 dB postoperatively. The postoperative air pure tone thresholds were significantly smaller than the preoperative values (p < 0.01). The air-bone gap was 30.5 dB at 500 Hz, 31.6 dB at 1 KHz, and 24.1 dB at 2 kHz preoperatively, and 7.7 dB at 500 Hz, 7.2 dB at 1 KHz, and 7.1 dB at 2 kHz postoperatively at the end of 6 months of follow-up. There were significant hearing gains in the air-bone gap (p < 0.001).

Conclusion Glass ionomer cement is a useful and effective material for bridging the defect of the long process of the incus.

Keywords

glass ionomer cement - hearing loss - ossiculoplasty - audiometry


Publication History

Received: 18 October 2021

Accepted: 01 December 2021

Article published online:
14 June 2022

© 2022. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Verhoeff M, van der Veen EL, Rovers MM, Sanders EA, Schilder AG. Chronic suppurative otitis media: a review. Int J Pediatr Otorhinolaryngol 2006; 70 (01) 1-12
    CrossrefPubMedGoogle Scholar
  • 2 Haidar H, Sheikh R, Larem A. et al. Ossicular chain erosion in chronic suppurative otitis media. Otolaryngol (Sunnyvale) 2015; 5 (203) 2
    Google Scholar
  • 3 Varshney S, Nangia A, Bist SS, Singh RK, Gupta N, Bhagat S. Ossicular chain status in chronic suppurative otitis media in adults. Indian J Otolaryngol Head Neck Surg 2010; 62 (04) 421-426
    CrossrefPubMedGoogle Scholar
  • 4 Dubey SP, Larawin V. Complications of chronic suppurative otitis media and their management. Laryngoscope 2007; 117 (02) 264-267
    CrossrefPubMedGoogle Scholar
  • 5 Albu S, Babighian G, Trabalzini F. Prognostic factors in tympanoplasty. Am J Otol 1998; 19 (02) 136-140
    PubMedGoogle Scholar
  • 6 Yung M. Long-term results of ossiculoplasty: reasons for surgical failure. Otol Neurotol 2006; 27 (01) 20-26
    CrossrefPubMedGoogle Scholar
  • 7 Helms J, Geyer G, Wanek E, Zollner W, Gasser O. Bone replacement part made of glass ionomer cement. Google Patents; 1994
    Google Scholar
  • 8 Babighian G. Use of a glass ionomer cement in otological surgery. A preliminary report. J Laryngol Otol 1992; 106 (11) 954-959
    CrossrefPubMedGoogle Scholar
  • 9 Galy-Bernadoy C, Akkari M, Mathiolon C, Mondain M, Uziel A, Venail F. Comparison of early hearing outcomes of type 2 ossiculoplasty using hydroxyapatite bone cement versus other materials. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131 (05) 289-292
    CrossrefPubMedGoogle Scholar
  • 10 Kalcıoğlu MT, Uzun İH, Yalçın M, Malkoç MA, Öğreten AT, Hanege FM. Evaluation on shear bond strength of different glass ionomer and hydroxy apatite cements used in ossiculoplasty. Balkan Med J 2015; 32 (01) 23-29
    CrossrefPubMedGoogle Scholar
  • 11 Yazıcı H, Uzunkulaoğlu H, Emir HK, Kızılkaya Z, Doğan S, Samim E. Comparison of incus interpositioning technique versus glass ionomer cement application in type 2 tympanoplasty. Eur Arch Otorhinolaryngol 2013; 270 (05) 1593-1596
    CrossrefPubMedGoogle Scholar
  • 12 Watson GJ, Narayan S. Bone cement: how effective is it at restoring hearing in isolated incudostapedial erosion?. J Laryngol Otol 2014; 128 (08) 690-693
    CrossrefPubMedGoogle Scholar
  • 13 Brask T. Reconstruction of the ossicular chain in the middle ear with glass ionomer cement. Laryngoscope 1999; 109 (04) 573-576
    CrossrefPubMedGoogle Scholar
  • 14 Dere H, Ozdogan F, Ozcan KM, Selcuk A, Ozcan I, Gokturk G. Comparison of glass ionomer cement and incus interposition in reconstruction of incus long process defects. Eur Arch Otorhinolaryngol 2011; 268 (11) 1565-1568
    CrossrefPubMedGoogle Scholar
  • 15 Tysome JR, Harcourt J. How we do it: ionomeric cement to attach the stapes prosthesis to the long process of the incus. Clin Otolaryngol 2005; 30 (05) 458-460
    CrossrefPubMedGoogle Scholar
  • 16 O'Reilly RC, Cass SP, Hirsch BE, Kamerer DB, Bernat RA, Poznanovic SP. Ossiculoplasty using incus interposition: hearing results and analysis of the middle ear risk index. Otol Neurotol 2005; 26 (05) 853-858
    CrossrefPubMedGoogle Scholar
  • 17 Babu S, Seidman MD. Ossicular reconstruction using bone cement. Otol Neurotol 2004; 25 (02) 98-101
    CrossrefPubMedGoogle Scholar
  • 18 Kjeldsen AD, Grøntved AM. Tympanoplasty with ionomeric cement. Acta Otolaryngol Suppl 2000; 543 (543) 130-131
    CrossrefPubMedGoogle Scholar
  • 19 Wegner I, van den Berg JW, Smit AL, Grolman W. Systematic review of the use of bone cement in ossicular chain reconstruction and revision stapes surgery. The Laryngoscope. 2015 Jan;125(1):227-233
  • 20 Somers T, Van Rompaey V, Claes G. et al. Ossicular reconstruction: hydroxyapatite bone cement versus incus remodelling: how to manage incudostapedial discontinuity. Eur Arch Otorhinolaryngol 2012; 269 (04) 1095-1101
    CrossrefPubMedGoogle Scholar
  • 21 Celenk F, Baglam T, Baysal E. et al. Management of incus long process defects: incus interposition versus incudostapedial rebridging with bone cement. J Laryngol Otol 2013; 127 (09) 842-847
    CrossrefPubMedGoogle Scholar
  • 22 Driscoll CL, Green JD, Beatty CW, McCaffrey TV, Marrs CD. In vitro characteristics of a glass ionomer cement. Skull Base Surg 1998; 8 (04) 175-180
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Celik H, Aslan Felek S, Islam A, Demirci M, Samim E, Oztuna D. The impact of fixated glass ionomer cement and springy cortical bone incudostapedial joint reconstruction on hearing results. Acta Otolaryngol 2009; 129 (12) 1368-1373
    CrossrefPubMedGoogle Scholar