Evaluatıon of clınıcal and audıologıcal results of bone cement use ın otologıcal surgery

Objective: The aim of this study is to evaluate the clinical and audiological outcomes of otologic surgeries performed using bone cement. Materials and Methods: In this study, 58 patients who underwent otologic surgery between January 2015 and December 2024 at the Department of Otorhinolaryngology, Farabi Hospital, Karadeniz Technical University, were retrospectively analyzed. The preoperative and postoperative otoscopic findings, audiological evaluations, surgical notes, demographic data, surgical approach, graft materials, presence of cholesteatoma, and occurrence of complications were recorded. Patients were classified according to the Austin-Kartush system, and subgroup analyses were conducted. Results: A general improvement was observed in postoperative air-bone gap (ABG), with success rates varying according to the Austin-Kartush groups. The best results were achieved in Group F(Fixed stapes), w here 100% of the patients had a postoperative ABG between 0–20 dB (mean: 13.2 dB). In contrast, Group A(M+S+) had a functional success rate (≤20 dB) of only 31.6%, with a mean postoperative ABG of 25.6 dB. Postoperative ABG was higher in patients with granular mucosa (28.7 dB) than in those with normal mucosa (21.8 dB) (p=0.013). The mean postoperative ABG was 21.3 dB in patients with a normal tympanic membrane and 31.2 dB in those with a retracted/adhesive membrane (p=0.010). Postoperative ABG was 22.3 dB in female patients and 29.4 dB in males (p=0.011). Patients with an otorrhea score of 0 had a mean ABG closure of 14.5 dB, whereas those with a score of 2 had only 2.8 dB (p=0.010). Conclusion: Bone cement is a reliable adjunctive material, particularly in otosclerosis surgery. However, surgical success is significantly influenced by preoperative middle ear status, ossicular integrity, and patient-specific factors. Group-based analyses revealed that while certain ossicular chain configurations can yield high success rates, others may require alternative surgical approaches.