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May 1989

'Tripod' Ossiculoplasty in Incudal Lesions

Author Affiliations

From the Departments of Otolaryngology, Meir Hospital, Kfar Saba, Israel, and Sackler School of Medicine, Tel Aviv (Israel) University.

Arch Otolaryngol Head Neck Surg. 1989;115(5):596-599. doi:10.1001/archotol.1989.01860290054014

• A method of ossiculoplasty, in cases where the long process of the incus is eroded, is described. The defect created by the erosion of the incus is bridged by an autogenic or allogenic bone graft that leans on the stapes, the remaining part of the incus, and the side of the malleus. These three contact points allow for stability of the bony graft and account for the name tripod. The method was applied in 30 ears and was successful in all but three cases. All the rest (ie, 27 ears) achieved an average gain of 24.8 dB, leaving an average air-bone gap of 11.1 dB. The postoperative air-bone gap was 20 dB or less in all 27 ears that were successfully operated on; and in 21 of them (77.8%), it was no more than 10 dB. The average period of follow-up was 23.8 months. Operative success depended on both the technique chosen and the favorable selection of cases.

(Arch Otolaryngol Head Neck Surg 1989;115:596-599)