Comparative study of new autologous material, bone-cartilage
composite graft, for ossiculoplasty with Polycel
Department of Otorhinolaryngology-Head
and Neck Surgery, College of Medicine, The
Catholic University of Korea, Seoul, Korea
S. N. Park, Department of Otolaryngology
Head & Neck Surgery, Seoul St. Mary’s
Hospital, College of Medicine, The Catholic
University of Korea, Seoul, Korea.
Objective: Ossiculoplasty is a surgical procedure that recreates sound transmission
of the middle ear in conductive hearing loss. Various materials have been used for
ossicular reconstruction, but the most ideal material for ossiculoplasty remains con-
troversial. The purpose of this study was to introduce a novel method of autologous
ossiculoplasty, bone-cartilage composite graft (BCCG) and to compare its surgical
results with different types of ossiculoplastic prostheses.
Study Design: A retrospective study was performed in a tertiary referral centre.
Methods: Data of 275 patients who received ossiculoplasty using the three differ-
ent materials of BCCG, Polycel
and titanium were analysed according to type of
ossiculoplasty: partial or total ossicular replacement prosthesis (PORP or TORP).
Hearing results, complication rates and clinical parameters including age, sex, past
history, preoperative diagnosis and surgery type were compared among different
Results: Ossiculoplasty with BCCG showed satisfactory hearing outcomes and the
lowest complication rate among the three different materials. In particular, its extru-
sion rate was 0%.
Conclusion: We propose that the BCCG technique is a useful alternative method
for ossiculoplasty, with proper patient selection.
Ossiculoplasty is a surgical technique for reconstruction of the
ossicular chain in conductive hearing loss caused by suppurative
chronic otitis media (OM), cholesteatoma or disruption of the
ossicular chain for any reason. As myringostapediopexy was intro-
duced in 1901, many otolaryngologists have performed ossiculo-
plasty and tried to achieve better hearing outcomes.
Reconstruction of the ossicular chain can be performed using
autologous cartilage, bone or synthetic materials such as vinyl-
acryl, polyethylene, gold, plastipore, hydroxyapatite, bioglass and
titanium. Technical advances in ossiculoplastic materials have
resulted in better surgical outcomes, but the most ideal material
for ossiculoplasty remains controversial.
We propose that autologous cartilage, ossicle and bone chips
from the mastoid cortex are excellent materials for ossicular recon-
struction that are comparable to other synthetic materials once
properly reshaped. Better long-term hearing results and a lower
extrusion rate were expected with these biocompatible autologous
Bone-cartilage composite graft (BCCG) is a novel method of
autologous ossiculoplasty with a mushroom-shaped graft made by
reshaped incus and conchal cartilage. This study introduced the new
technique of ossiculoplasty using BCCG and compared its hearing
outcomes and complication rates with those of synthetic prostheses
MATERIALS AND METHODS
The clinical data of 275 patients who underwent ossiculoplasty
between January of 2009 and December of 2012 were retrospec-
tively reviewed and followed up to December 2014. Preoperative clin-
ical characteristics including demographic data, hearing levels, past
history, preoperative diagnosis and surgery type were collected and
Accepted: 19 September 2017
© 2017 John Wiley & Sons Ltd wileyonlinelibrary.com/journal/coa Clinical Otolaryngology. 2018;43:434–439.