الفهرس 
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Abstract
Menoufia, Egypt.
Approval from Institutional Review Board of Menoufia University
and informed patient consents in March 2018, were obtained before
patient recruitment.
All patients with a moderate degree of conductive hearing loss
resulting from either chronic suppurative otitis media, adhesive otitis
media or traumatic ossicular dislocation, were included in our study.
Patients with mixed hearing loss, otosclerosis, frozen attic syndrome
or extensive cholesteatoma, were excluded.
All patients were subjected to history taking, general examination,
and otoscopic evaluation. Patients were assigned to each of the three
techniques according to length of incus defect.
Incus was cleaned and the short process of incus or remnant of any
process was removed leaving the longer process to fashion the incus into
a ”teardrop” shape (IT). Then, we used a micro drill to create a depression
in the opposite side of the retained process.
In the absence of incus, cortical bone from the mastoid region was reshaped
to the form with the above-mentioned criteria (CBA).
The powder (polycarboxylic acid and pigments) and the liquid
(water and tartaric acid) component of BC were mixed till reaching pastelike
consistency then it was applied to the ossicular defect.
Pre-operative and 6 months post-operative audiograms (PTA) were
obtained and results of air bone gap (ABG) were statistically analyzed.
Summary
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Our patients ranged between 10-50 years old and out of total 21
subjects, 10 patients were male (4 patients in IT, 3 patients in CBA, and 3
patients in BC) with no statistically significant difference in age, sex
between the three groups (IT, CBA, and BC) with p-value (0.809, and
0.826 for each age and sex)
For IT group, the mean for pre- PTA was 50.57 with SD (5.13), it
became 30.86 (1.86) after 6 months of follow-up.
For CBA, pre- PTA mean was 50.86 (5.67) that finally became 32.14
(2.41) achieving PTA gain 18.71 (6.68).
BC PTA was decreased from 32.14 (5.55) to 19.57 (3.82) with mean
gain 12.57 (3.15)
Significant statistical difference between pre-post groups in all three
surgical procedures (p-value < 0.05).
In terms of Belfast Rule of Thumb, 4 patients in each of the three
technique (57.14 %), achieved less than 15 dB interaural difference or
less than 30 dB hearing thresholds for PTA
Regarding side effects in each technique, few side effects were
reported in each one, with no significant difference in adverse effects
between the three group (P-value= 0.494)
Both BC, IT and CBA are reliable techniques for ossiculoplasty with
good postoperative hearing results. The choice of the proper technique
depends on length of incus defects.