Comparing the Audiological Success of Bone Cement to Standard Ossiculoplasty Techniques: A Systematic Review and Meta-analysis.

Abstract

To compare the audiological success and longevity of bone cement to standard ossiculoplasty techniques. PubMed, Embase, Cochrane Library, Medline, and the Web of Science were systematically searched for studies from the date of inception to November 8, 2024. Two independent reviewers screened for eligibility. Inclusion criteria were full-text, English language publications. Human studies of any methodology except case series with fewer than five patients were included. The Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines were followed. Data were pooled using a random-effects model using relative risk with 95% CIs. Prespecified primary outcomes compared the success of bone cement reconstruction at short and longer-term follow-up. A total of 27 studies met the eligibility criteria. Bone cement resulted in better audiological outcomes (postoperative mean air-bone gap < 20 dB HL) compared to incus interposition, risk ratio (RR): 1.26 (95% CI: 1.10-1.43). There was no difference in success between bone cement and partial ossicular replacement prosthesis (PORP), RR: 1.15 (95% CI: 0.94-1.41). The findings of this review suggest that bone cement remains successful at a longer-term follow-up. Bone cement outperforms incus interposition and is comparable to PORP for audiological outcomes. Audiological improvement is sustained into longer-term follow-up.