Role of ionomeric bone cement in primary stapedotomy for otosclerosis

Abstract

Objective: Crimping of the prosthesis in the primary stapedotomy is a controversial step that can have a great impact on the long-term success of the procedure. The study aims to clarify the role of bone cement in primary stapedotomy with an assessment of the postoperative hearing state. Methods: A prospective randomized clinical study including patients with otosclerosis was conducted. The study population was divided into two equal groups. Group A had primary stapedotomy with crimping of the prosthesis while group B had the procedure with bone cement bridging between the prosthesis and a long process of the incus replacing the crimping step. Data of included patients were collected and included gender, age, family history, and audiological parameters. The outcome measurement was the improved hearing status postoperatively as shown by the 1-month postoperative audiogram. The long-term outcome was the stability of the prosthesis that was measured by the 6-month postoperative audiogram. Results: Sixty patients were included in the study. A statistically significant improvement of the hearing state was present in both groups in all frequencies (p <0.05). The difference in postoperative air-bone gap at 2000 Hz between both groups was statistically significant (p <0.05) with better closure in group B. The follow-up period was 1 year postoperatively in all patients. Conclusion: The use of hydroxyapatite bone cement in primary stapedotomy may have a role in providing stability for the procedure decreasing the incidence of recurrent conductive hearing loss in otosclerosis patients. This can provide a substitute for the problems of malcrimping of the prosthesis.