A 40-year-old man with unsafe chronic suppurative otitis media undergoes exploration of the middle ear. The long process of the incus is eroded but the stapes superstructure is intact and mobile. Which prosthesis is most appropriate for ossicular reconstruction?

• A Total ossicular replacement prosthesis (TORP)
• B Direct fascia-to-footplate coupling
• C Autologous malleus head interposition
• D Partial ossicular replacement prosthesis (PORP) ✓

Explanation

A PORP connects the tympanic membrane or malleus handle to an intact stapes head, which suits this patient whose stapes superstructure is preserved. A TORP is reserved for when the stapes superstructure is also absent and only the mobile footplate remains, so it would bypass a functioning stapes unnecessarily. Autologous malleus interposition requires an intact incudostapedial continuity that does not exist here.

Reference: Scott-Brown's Essential Otorhinolaryngology, 3rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.