Assessment of efficacy of glass ionomer cement in incudostapedial reconstruction ossiculoplasty: an observational follow-up study

Abstract Background Ossicular discontinuity is a common cause of conductive hearing loss in chronic otitis media, most frequently involving erosion of the long process of incus. Restoration of ossicular continuity is essential to re-establish the middle ear transformer mechanism. While several materials have been described for ossiculoplasty, an ideal material that is cost-effective, biocompatible, stable, and easily applicable continues to be sought. Glass ionomer cement (GIC), widely used in dentistry, has recently gained attention for incudostapedial reconstruction in cases with small ossicular gaps. Methods This observational follow-up study included patients with chronic otitis media undergoing tympanoplasty who were intraoperatively found to have incudostapedial discontinuity of ≤ 2 mm. Glass ionomer cement was used to bridge the defect and restore ossicular continuity. Pure tone audiometry was performed preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. Outcomes assessed included improvement in pure tone average (PTA), air-bone gap (ABG), graft uptake, and procedure-related complications. Results Sixteen patients were included in the final analysis. A statistically significant improvement was observed in mean PTA and ABG at all postoperative follow-up intervals compared to preoperative values, as assessed by repeated measures ANOVA ( p < 0.05). Most patients achieved postoperative ABG closure to within 20 dB. No major intraoperative or postoperative complications related to glass ionomer cement were encountered during the follow-up period. Conclusion Glass ionomer cement is a safe, effective, and economical material for incudostapedial reconstruction in selected cases with small ossicular defects. It allows physiological restoration of ossicular continuity and provides satisfactory hearing outcomes, making it a valuable alternative in resource-limited settings.