الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Many studies show that in safe type of CSOM, approximately one-fifth patients are having ossicular necrosis. The long process of the incus is most vulnerable to both trauma and infectious processes. This results in incudostapedial joint discontinuity, which in turn causes a conductive hearing loss. Different techniques have been described to reconstruct incudostapedial joint continuity, including interposition of a biological autograft or homograft, and use of partial ossicular replacement prostheses (PORPs) and most recently, bone cements. Bone cements (BC), initially used in the dental field, are becoming more popular in otology for ossiculoplasty. Incus interposition refers to using a sculptured incus to connect the stapes into the handle of malleus. Aim of this study: This study aimed to compare the hearing results of bone cement ossiculoplasty (ISRO) and incus interposition (IP) in patients with incus long process defects due to CSOM. Method: This study is a prospective randomized clinical trial involving thirty patients with incus long process defects. Bone cement ossiculoplasty was performed in 15 patients (group A), Incus interposition was performed in 15 patients (group B). group A included 10 female and 5 male patients, with a mean age ± standard deviation of 29.40±11.37years (range,18–55 years). group B comprised 7 female and 8 male patients, with a mean age ± standard deviation of 26.53±10.45 years (range, 18–53 years). Results: The mean hearing gain ± standard deviation was 24.47±5.25 dB in group A and 20.0±4.79 dB in group B. Hearing gain was significantly greater in the bone cement group than in the incus interposition group(p = 0.02). Successful hearing results (i.e., air–bone gap < 20 dB) were achieved by 80% of group A patients and 73.3% of group B patients. Conclusion: Bone cement ossiculoplasty and Incus interposition are safe and reliable methods with which to manage incus long process defects. Bone cement ossiculoplasty gives a greater hearing gain in appropriate cases. Recommendations: Further comparative prospective studies, with a larger sample size and longer follow-up period, are needed to standardize a particular ossiculoplasty procedure.