Electrocoagulation improving bone cement use in middle-ear surgery: short-term and middle-term results.

BACKGROUND: Bone cement is used for ossicular chain repair and revision stapes surgery. Its efficient use requires cautious removal of mucosa from the ossicles. This paper reports a technique for easy, fast and safe removal of this mucosa prior to cement application. It consists of the application of monopolar electrocoagulation on the ossicles prior to bone cement application.

METHODS: The outcomes of six cases of revision stapes surgery and seven cases of partial ossiculoplasty, conducted between 2007 and 2012 using this new technique, were evaluated. Intra-operative reports and audiometric data were collected.

RESULTS: During the last assessment, reconstruction using bone cement resulted in mean post-operative air-bone gaps of 4.1 ± 6.5 dB in revision stapes surgery cases and 5.7 ± 5.5 dB in partial ossiculoplasty cases, reflecting a significant hearing improvement (p = 0.03). No complications were observed.

CONCLUSION: Electrocoagulation allows the removal of mucosa from the ossicles in an easy, fast and safe manner, enabling the use of bone cement for ossicular chain reconstruction.