Comparing the Audiological Success of Bone Cement to Standard Ossiculoplasty Techniques: A Systematic Review and Meta-analysis

OBJECTIVE: To compare the audiological success and longevity of bone cement to standard ossiculoplasty techniques.

DATA SOURCES: PubMed, Embase, Cochrane Library, Medline, and the Web of Science were systematically searched for studies from the date of inception to November 8, 2024.

REVIEW METHODS: Two independent reviewers screened for eligibility. Inclusion criteria were full-text, English language publications. Human studies of any methodology except case series with fewer than five patients were included. The Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines were followed. Data were pooled using a random-effects model using relative risk with 95% CIs. Prespecified primary outcomes compared the success of bone cement reconstruction at short and longer-term follow-up.

RESULTS: A total of 27 studies met the eligibility criteria. Bone cement resulted in better audiological outcomes (postoperative mean air-bone gap < 20 dB HL) compared to incus interposition, risk ratio (RR): 1.26 (95% CI: 1.10-1.43). There was no difference in success between bone cement and partial ossicular replacement prosthesis (PORP), RR: 1.15 (95% CI: 0.94-1.41). The findings of this review suggest that bone cement remains successful at a longer-term follow-up.

CONCLUSION: Bone cement outperforms incus interposition and is comparable to PORP for audiological outcomes. Audiological improvement is sustained into longer-term follow-up.