Complete Malleus Removal for Cholesteatoma: A Multivariate Analysis of Ossiculoplasty Success and Residual Disease

Shapiro, Scott; Bennett, Donald R.; Wetmore, Stephen J.; Cassis, Adam

doi:10.1177/0003489417743519

Cited by 5 publications

(1 citation statement)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 2 It is not uncommon that the handle of malleus cannot be used in the reconstruction of the ossicular chain because it is either too far anterior for a stable assembly, destroyed by extensive disease, the tensor tendon cut, or the malleus removed in its entirety by the surgeon for adequate access to the epi/protympanum. 2 , 3 The resultant ossiculoplasty now bridges between the mobile stapes superstructure and the tympanic membrane, with or without interposing cartilage for reinforcement. Therefore, 3 major groups may be encountered:…”

Section: Introductionmentioning

confidence: 99%

Tympanoplasty with an Intact Stapes Superstructure in Chronic Otitis Media

Schlemmer

Liu

Linder³

2021

Int Adv Otol

View full text Add to dashboard Cite

BACKGROUND: The objective of our study was to ascertain the functional results in terms of air bone gap (ABG) closure over 4 frequencies (0.5, 1, 2, 3 kHz) in patients with chronic otitis media (COM) that underwent tympanoplasty in the presence of a mobile stapes superstructure, and in particular excluding those cases in which the malleus was used in the reconstruction. Methods: A retrospective review of our database between January 1, 2006 and June 1, 2018 identified all cases that underwent one of 3 reconstructive options: the classic Type III tympanoplasty in an open-cavity setting; the “stapes augmentation” (SA) type reconstruction where the stapes superstructure is augmented to the drum by an interposing partial ossiculoplasty of either autologous bone, cartilage, or prosthetic material; and the use of a total articular replacement prosthesis (TORP) from the stapes footplate to the drum in the presence of an intact superstructure. Results: A total of 116 procedures in 112 patients were identified with a mean ABG reduction from 27 dB to 21 dB ( P < .05). There was no significant difference in the mean post-operative ABG result between Type III (19.21 dB), TORP+ (24.90 dB), or SA (20.94 dB) reconstructions ( P = .368). Overall, an ABG ≤ 20 dB or “surgical success” was achieved in 56% ( n = 65) of cases. Only 20% ( n = 23) of cases had “failure” or a post-operative ABG >30 dB. Conclusion: Tympanoplasty with an intact stapes superstructure in COM is expected to provide acceptable levels of surgical success. We did not identify any particular risk factors associated with improved outcome.

show abstract

Section: Introductionmentioning

confidence: 99%