During ossicular chain reconstruction in a patient with chronic otitis media, the surgeon finds the stapes superstructure intact and mobile but the entire incus destroyed. Which prosthesis is appropriate to restore continuity between the tympanic membrane graft and the stapes head?
- A Total ossicular replacement prosthesis (TORP)
- B Partial ossicular replacement prosthesis (PORP) ✓
- C Hydroxyapatite incus strut anchored to the malleus handle
- D Autologous cortical bone columella placed on the footplate
Correct answer: B. Partial ossicular replacement prosthesis (PORP)
Explanation
A PORP sits on the stapes head and connects it to the graft or drum when the superstructure is present but the incus is lost. A TORP is used when even the stapes superstructure is missing, resting instead on the footplate. Placing any prosthesis on the footplate risks perilymphatic fistula and is reserved for the TORP situation, so option D is inappropriate here.
Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.