The first ossicle to show erosion in cholesteatoma is the long process of the incus. The ossicular chain reconstruction technique using the patient's own eroded incus reshaped as an interposition graft is called:

• A Columella technique
• B TORP placement
• C Incus transposition ✓
• D PORP placement

Explanation

Incus transposition involves removing the incus, reshaping it, and reinserting it between the malleus handle and the stapes head (or footplate if the suprastructure is absent) — utilizing autologous bone for ossiculoplasty. This avoids extrusion risks of synthetic prostheses. PORP (partial ossicular replacement prosthesis) replaces the incus when stapes suprastructure is intact, placed from stapes head to malleus handle. TORP (total ossicular replacement prosthesis) is used when stapes suprastructure is also absent, resting on the footplate. The columella technique historically refers to a simple strut reconstruction.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.