Exclusive Endoscopic Double Cartilage Block (DCB) PORP

To begin, prepare all the necessary surgical tools and equipment for the procedure. To prepare the double cartilage block or DCB graft, obtain a rectangular block of tragal or conchal cartilage and remove the perichondrium on one side only. Cut the cartilage in half using a scalpel, ensuring to refrain from cutting through the perichondrium on the opposing side.

Create a shallow acetabulum approximately 1 millimeter wide to recede the stapes capitulum on the block, free from perichondrium. Fold the cartilage block on the intact perichondrium. Then position the DCB inside the tympanic cavity, and locate precisely onto the stapes head using a micro suction tip or needle.

Ensure the stability of the reconstruction by using resorbable gelatin sponges, and carefully cover the DCB with the tympanomeatal flap. The overall graft intake rate showed a success rate of 98.3%Preoperatively, the average air-bone gap was 28.90 decibels, whereas after surgery, the average air-bone gap was reduced to 24.50 decibels.