A patient undergoing ossiculoplasty has an intact stapes superstructure but an eroded malleus head and incus. Which prosthesis is most appropriate?

• A Total ossicular replacement prosthesis (TORP)
• B Stapes piston placed through a fenestrated footplate
• C Autologous incus interposition between malleus handle and oval window
• D Partial ossicular replacement prosthesis (PORP) ✓

Explanation

A PORP connects the tympanic membrane or malleus handle to an intact stapes head, so it is chosen when the stapes superstructure is preserved. A TORP is required only when the entire stapes crura are absent and the prosthesis must sit on the footplate. Incus interposition needs both a usable incus body and an intact malleus handle connection, which is not the case here. A stapes piston is used in otosclerosis with a mobile malleus and incus.

Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.