OTOLOGY Comparison of glass ionomer cement and incus interposition in reconstruction of incus long process defects Huseyin Dere • Fatih Ozdogan • K. Murat Ozcan • Adin Selcuk • Ibrahim Ozcan • Gokhan Gokturk Received: 27 June 2010 / Accepted: 22 September 2010 / Published online: 22 February 2011 Ó Springer-Verlag 2011 Abstract The ossicles may be affected through the mass effect of the pathological tissue in chronic otitis media. Ossicular reconstruction may be accomplished using the patients’ own ossicles or with alloplastic materials. Glass ionomer ossiculoplasty is a fast, efficient, safe and cost- effective method and it has been used more frequently in recent years. Forty-six patients who had surgery for chronic otitis media were included in this study. All patients had an incus long process defect and a normal stapes superstruc- ture. Ossicular reconstruction was performed using glass ionomer cement (GIC) (Ketac-Cem, Espe Dental AG, Seefeld, Germany) in 23 patients (group 1), while incus interposition was performed in other 23 patients (group 2). Preoperative and postoperative air pure tone averages of the group 1 patients were 42.8 and 35.2 dB, respectively (p \ 0.01). These values were 42.9 and 34.5 dB in group 2 (p \ 0.01). Two groups were similar with respect to post- operative hearing gain (p [ 0.05). The air bone gap of group 1 was 27 dB preoperatively and 20.7 dB postopera- tively. These values were 28.7 and 20.2 dB, respectively, in group 2. The closure of air bone gap was statistically sig- nificant in both the groups (p \ 0.01, p \ 0.01). The comparison of the mean gains of the air bone gap revealed no difference between the groups (p [ 0.05). In conclusion, the use of both GIC ossiculoplasty and incus interposition are efficient methods for reconstruction of incus long process and one is not superior to the other. A larger study population may be useful for comparison of these methods. Keywords Glass ionomer cement Á Incus interposition Á Ossiculoplasty Introduction The ossicular chain conducts the sound effectively into the inner ear. The disease of the middle ear and ossicles disturb the energy transfer and conductive hearing loss appears [1]. Ossicular reconstruction is most frequently performed due to the loss of incus or incus defects. Austin [2] reported that malleus and stapes superstructure were present in 60% of the ossicular defects. Recently, glass ionomer cement (GIC) has been used frequently in otology and neurotology. At the beginning, this material was used in the dental region; however, later, it has been used for cranioplasty, reconstruction of tegmen and external ear canal, mastoid obliteration, ossicular reconstruction and stabilization of various implants [1]. Incus interposition or transposition is another method used for ossicular reconstruction. Incus interposition was first described by Hall and Rytzner in 1956 and it has been used thereafter [3]. The aim of this study is to compare the results of GIC reconstruction and incus interposition in patients with ossicular discontinuity due to incus long process defects. Materials and methods Forty-six patients with an incus long process defect and normal malleus and stapes superstructure were included in this study, out of 495 patients who had surgery due to Presented at 31st Turkish National Congress of Otorhinolaryngology and Head and Neck Surgery, 28 October to 1 November 2009, Antalya, Turkey. H. Dere Á F. Ozdogan (&) Á K. M. Ozcan Á A. Selcuk Á I. Ozcan Á G. Gokturk Ankara Numune Education and Research Hospital 4th ENT Clinic, Bagci caddesi 60/4, Etlik, Ankara, Turkey e-mail: ozdogan.fatih@gmail.com 123 Eur Arch Otorhinolaryngol (2011) 268:1565–1568 DOI 10.1007/s00405-010-1454-1