Results of gold prosthesis for ossicular chain reconstruction in tympanoplasty

The use of prosthesis in middle ear reconstruction has significantly improved the results in hearing after surgery. Most available prostheses used in literature have produced varying results. The goal of attaining hearing improvement after such surgeries ossiculoplasty became a rule rather than an exception. Since the widely established prostheses such as plastipore and titanium are rather expensive for the average Indian patient, we have tried to evaluate the results using economical and readily available gold prosthesis. Aim: To evaluate gold prosthesis in ossicular chain reconstruction and compare its results with plastipore, cartilage and bone. Materials and Methods: This is a prospective study comprising of 59 patients who underwent ossicular chain reconstruction in the Dept. of ENT & Head & Neck Surgery at a tertiary centre, between January 2003 and Oct 2005. These patients were diagnosed to have Chronic Suppurative Otitis Media; 31 patients had tubotympanic and 28 patients had atticoantral disease. 22 patients underwent tympanoplasty with use of gold prosthesis while 37 patients underwent tympanoplasty with cartilage, bone or plastipore. Chi-square test was used to compare gold prosthesis with these other materials in regards to postoperative results i.e. air-bone gap closure. Results: Good hearing improvement (AB gap<30db) was noted in 45% of the patients who underwent tympanoplasty with gold prosthesis at follow up of 1 and 6 months. Conclusion: Gold prosthesis is an effective and cost effective alternative to plastipore as an ossicular reconstruction material.