A 40-year-old man with long-standing CSOM undergoes exploration. Intraoperatively the malleus and incus are eroded, but the stapes superstructure is intact and mobile. Which prosthesis is most appropriate for ossicular reconstruction?

• A TORP (total ossicular replacement prosthesis)
• B PORP (partial ossicular replacement prosthesis) ✓
• C Stapes piston prosthesis
• D Autologous incus interposition between handle of malleus and stapes head

Explanation

A PORP connects the tympanic membrane or graft directly to an intact stapes head and superstructure, so it is chosen when the stapes superstructure is present. A TORP is required only when the superstructure is absent and the prosthesis must sit on the footplate. A stapes piston is used in otosclerosis, and incus interposition needs an intact malleus handle, which this patient lacks.

Reference: Scott-Brown's Essential Otorhinolaryngology, Head and Neck Surgery ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.