Total Ossicular Chain Reconstruction: Is Autologous Material Better Than a TORP?

TORPs may offer superior hearing outcomes compared with autologous grafting materials for total ossicular chain reconstruction. Patients with cholesteatoma and middle ear mucosal pathology have less favorable hearing outcomes. Bone frequently fuses to the surrounding bone in the middle ear and should be used with caution. Autologous cartilage reconstruction remains a reasonable option in high-risk ears or in patients where minimizing the risk of prosthesis extrusion or revision surgery is critical.