Autologous cartilage module for partial ossiculoplasty with additional fixation using Sulfacryl adhesive in chronic suppurative otitis media

Introduction. Chronic purulent otitis media (HCSO) is an urgent problem in otorhinolaryngology. Surgical treatment is aimed at rehabilitation and reconstruction of the middle ear to improve hearing. Damage to the chain of the auditory ossicles, most often the long process of the anvil, occurs in 22.4-70% of cases of HCG and leads to conductive or mixed hearing loss. The treatment includes the installation of a prosthesis to restore the sound pathway. Artificial (titanium, ceramic, polyethylene) and autologous (cartilage, bone) prostheses are used. Artificial dentures have the risk of extrusion and high cost, requiring additional shelter. Autologous prostheses are cheaper, but they are subject to remodeling, difficult to manufacture, and prone to excessive fixation. All prostheses can be displaced (10-25% of cases) due to dysfunction of the auditory tube, impaired ventilation or adhesive processes, which leads to a recurrence of hearing loss.

The aim of the study. To develop a partial ossiculoplasty procedure, including stapedomyringopexy using a proprietary cartilage graft secured with Sulfacrylate glue.

Materials and methods. 34 patients (2023-2025) with HCG, adhesive otitis media and tympanosclerosis underwent stapedomyringopexy. Audiometry revealed conductive/mixed hearing loss (CVI 34.5±10.4 dB). The patients were divided into 2 groups: I (n=19) – autochondrial module, II (n=15) – sulfacrylate-fixed module. After 6 months, the defect is completely closed and hearing is improved. After 1 month, the CVI is 16±3.2 dB (improved air conductivity). In group I, the CVI increased to 23 dB by 6 months (dislocation of the prosthesis). In group II, the CVI is stable (≈17 dB), which indicates the reliability of sulfacrylate fixation.

Results and discussion.  The developed model of a cartilaginous prosthesis for the auditory ossicles is characterized by simplicity of manufacture and low cost. Its rigidity and standard dimensions ensure efficient sound transmission. Reliable fixation of the prosthesis on the stirrup leg is achieved using Sulfacrylate glue, which eliminates its displacement during the installation of a new eardrum or tympanomatal flap. This adhesive fixation contributes to the long-term stabilization of the prosthesis and its subsequent fusion with the connective tissue.

Conclusion. The use of this cartilaginous prosthesis in ossiculoplasty improves the functional results of the operation due to a stable connection with the head of the stirrup, which eventually leads to a more successful restoration of hearing.