The aim of this retrospective study was to evaluate the long-term hearing results of using costal cartilage
prostheses in ossicular chain reconstruction procedures in subjects operated on for a
middle ear cholesteatoma with an intact canal wall
tympanoplasty. Thirty-six patients (four with bilateral disease) followed up for 10 years who underwent an ossiculoplasty with a cartilage
prostheses between January 1987 and December 1989 constituted the population studied. All the subjects underwent a staged intact canal wall
tympanoplasty with
mastoidectomy. Ossiculoplasty with total or partial chondroprosthesis was performed during the second stage. The long-term outcome was evaluated in terms of hearing according to the guidelines of the Committee on Hearing and Equilibrium (1995), and in terms of complications (anatomical and functional). In 18 patients a partial cartilage
ossicular replacement prosthesis (
PORP) was used, while in 22 a total cartilage
ossicular replacement prosthesis (
TORP) was used. In the
PORP group the mean preoperative air-bone gap (ABG) was 22.4 dB hearing level (HL); before the second stage the ABG was 37.9 dB HL, at 2 years it was 12.1 dB HL, at 5 years 15.3 dB HL and
at 10 years 15.8 dB HL. In the
TORP group the mean preoperative ABG was 31.6 dB HL; before the second stage the ABG was 41.1 dB HL, at 2 years it was 14.4 dB HL, at 5 years 17 dB HL and
at 10 years 18.5 dB HL. In both groups the number of cases with a postoperative ABG of < 20 dB HL remained stable (P > 0.05) over time. The failure rate was 17.5%, but only in 5% of cases was a functional revision needed. No cases of extrusion of the
prostheses were encountered. The use of a chondroprosthesis is associated with functional results similar to those obtained by other authors. The efficacy of the
prostheses remains stable over time and is associated with a very low rate of complications and failures. In this series no extrusion occurred and in no case did an
infectious disease develop after cartilage
transplantation.