Displacement of a Total Ossicular Replacement Prosthesis Following Ossicular Chain Reconstruction

Ann Otol Rhinol Laryngol. 2021 Apr;130(4):420-423. doi: 10.1177/0003489420953587. Epub 2020 Aug 20.

Abstract

Objective: Herein we describe the diagnosis and management of total ossicular replacement prosthesis (TORP) displacement following tympanoplasty with ossicular chain reconstruction (OCR).

Methods: Case report with literature review.

Results/case: A 40-year-old male with otorrhea and tympanic membrane perforation underwent a right revision tympanoplasty with OCR using a TORP with a tragal chondroperichondrial graft. On postoperative day (POD) 4, he developed vertigo and profound right-sided hearing loss. Temporal bone computed tomography showed the prosthesis in the vestibule. After a steroid taper with mild improvement in symptoms, the TORP was removed two weeks later and the patient continued to improve.

Conclusion: TORP displacement into the vestibule is a very rare complication following OCR. Conservative management with high dose steroids may improve symptoms, however further middle ear exploration and surgical management may be warranted depending on the depth of displacement into the inner ear as well as symptom severity.

Keywords: displacement; ossicular chain reconstruction; ossicular replacement prosthesis; otology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Ear Ossicles / surgery*
  • Glucocorticoids / administration & dosage*
  • Humans
  • Male
  • Ossicular Prosthesis / adverse effects*
  • Ossicular Replacement* / adverse effects
  • Ossicular Replacement* / instrumentation
  • Ossicular Replacement* / methods
  • Plastic Surgery Procedures / methods
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / drug therapy
  • Postoperative Complications* / physiopathology
  • Prosthesis Failure*
  • Temporal Bone / diagnostic imaging
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Tympanic Membrane Perforation* / diagnosis
  • Tympanic Membrane Perforation* / etiology
  • Tympanic Membrane Perforation* / physiopathology
  • Tympanic Membrane Perforation* / surgery
  • Tympanoplasty* / adverse effects
  • Tympanoplasty* / methods
  • Vestibule, Labyrinth / diagnostic imaging

Substances

  • Glucocorticoids