Clin Exp Otorhinolaryngol.  2022 May;15(2):197-199. 10.21053/ceo.2021.01823.

“Cement Bridge Over Troubled Incus” Technique in Patients With Oval Window Atresia and Anomalous Incus: A Preliminary Report

• Jang P
• Lee SJ
• Koo JW
• Song JJ

• KMID: 2530167
• DOI: http://doi.org/10.21053/ceo.2021.01823

Figure

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  Fig. 1. Schematic illustration of the surgical procedures and intraoperative photographs. (A) A dysplastic rudimentary long process of the incus (LPI) and atresia of the oval window. (B) Vestibulotomy using a CO2 laser and preparation of a distance-adjusted piston wire prosthesis (PWP). (C) Insertion of the PWP into the vestibulotomy site and approximation of the PWP loop to the tip of the dysplastic LPI. (D) Bridging the PWP loop to the tip of the LPI using bone cement. (E, F) Intraoperative microscopic photographs after PWP insertion and approximation, respectively. (G, H) Intraoperative microscopic photographs after bridging using bone cement.

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  Fig. 2. (A-D) Preoperative (A1, B1, C1, and D1) and postoperative (A2, B2, C2, and D2) pure-tone audiograms of the three patients (four ears). Dotted line, bone conduction thresholds; solid line, air conduction thresholds.

Reference

1. Han SA, Choe G, Kim Y, Koo JW, Choi BY, Song JJ. Beware of a fragile footplate: lessons from ossiculoplasty in patients with ossicular anomalies related to second pharyngeal arch defects. J Clin Med. 2019; Dec. 8(12):2130.

2. Ahn SH, Kim DH, Choi JY, Kim BG. Two cases of malleostapedotomy in congenital oval window atresia. Korean J Audiol. 2013; Dec. 17(3):152–5.

3. Sennaroglu L, Bajin MD, Atay G, Gunaydın RO, Gonuldas B, Batuk MO, et al. Oval window atresia: a novel surgical approach and pathognomonic radiological finding. Int J Pediatr Otorhinolaryngol. 2014; May. 78(5):769–76.

4. Baglam T, Karatas E, Durucu C, Kilic A, Ozer E, Mumbuc S, et al. Incudostapedial rebridging ossiculoplasty with bone cement. Otolaryngol Head Neck Surg. 2009; Aug. 141(2):243–6.

5. Goebel JA, Jacob A. Use of mimix hydroxyapatite bone cement for difficult ossicular reconstruction. Otolaryngol Head Neck Surg. 2005; May. 132(5):727–34.