Neomalleus ossiculoplasty

Otol Neurotol. 2002 Sep;23(5):636-42. doi: 10.1097/00129492-200209000-00005.


Objective: To evaluate the role of ossiculoplasty techniques using neomalleus struts combined with assembly prostheses, in middle ear reconstruction.

Study design: A retrospective case review of 272 consecutive ossiculoplasty cases in which the malleus was replaced with an autograft strut.

Background: Current ossiculoplasty methods have experienced tangible difficulties, including extrusion and displacement (columellae), plus inefficiency and instability (assemblies).

Setting: Private single-surgeon tertiary referral otologic practice.

Patients: Ossiculoplasty candidates in whom the malleus was unsuitable for assembly reconstructions because of disease or malpositioning.

Interventions: Ossicular reconstructions using an autograft strut to replace an absent or malpositioned malleus, combined with Spanner assembly prostheses.

Main outcomes measures: Pure tone audiology, subdivided into Austin groups, and also progressive pathologic severity groups, using Surgical, Prosthetic, Infection, Tissues, Eustachian (SPITE) indicators.

Results: Two months postoperatively, neomalleus cases returned favorable results in comparison with those of previous techniques, in equivalent situations. The technique appeared to be durable in the longer term.

Conclusions: Neomalleus techniques offer enhanced success rates when the malleus handle is displaced, diseased, or absent.

MeSH terms

  • Audiometry, Pure-Tone
  • Ear Diseases / diagnosis
  • Ear Diseases / surgery
  • Humans
  • Malleus / surgery*
  • Ossicular Prosthesis*
  • Retrospective Studies