Data and Reporting Quality in Tympanoplasty and Ossiculoplasty Studies

Abstract

Objective The objective of our study was to check the documentation of hearing outcome parameters and influencing factors (surgical, pathological, and methodological) in published literature evaluating hearing outcome after tympanoplasty. We aimed to assess how effectively the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) 1995 guidelines were applied. Study Design Retrospective noncontrolled study. Setting Ear research center. Subjects and Methods This study was based on a PubMed research, including peer-reviewed English-speaking original studies published from January 2005 to December 2015. In total, 169 studies were checked for correct description of study population, surgical methodology, study design, and documentation of the hearing outcome. In addition, the correct application of AAO-HNS 1995 criteria was checked. Results Pre- and postoperative air-bone gap were shown as mean ± standard deviation in half of all series (52% vs 56%). The recommended frequency spectrum (0.5-3 kHz) was used in 46%, while a documentation of frequency spectrum was available in 85%. Whereas a statement on presence of stapes suprastructure (81%) and initial pathology was usually available, mucosa status (17%) and aeration (8%) were only shown in few series. Revision cases, staged cases, and myringoplasty graft material were documented in 46% to 57%. Type and material of prosthesis were represented in 74% to 82%. None of the publications analyzed fulfilled all 10 AAO-HNS criteria. In 10%, 7 to 9 criteria were used correctly. Conclusion A heterogeneous description of surgical and pathological findings and the application of minimal reporting standards are essential preconditions to enable comparisons between different studies and to generate meta-analysis.

Comparison of total and partial ossicular replacement prostheses in patients with an intact stapes suprastructure

“…According to recommendations in the hearing reporting standard and to the Committee on Hearing Equilibrium guidelines, only ABG3 was relevant for evaluating the results of treating conductive hearing loss. Therefore, only ABG3 was analyzed further and is referred to as ABG .…”

“…The underlying middle ear disease, status of the malleus handle, ventilation and mucosa of the middle ear, presence of the stapes suprastructure, surgical technique (e.g., canal wall up [CWU] vs. canal wall down [CWD]), reconstruction material, surgeon's experience, and number of previous ear surgeries seem to play a role in the outcome of surgery. Hence, it remains challenging to make comparisons among published data because hearing outcome depends on multiple factors and, to date, there is no standardized manner of documenting the extent of middle ear disease, details of surgery, and reporting of outcomes …”

Mastoid cavity obliteration leads to a clinically significant improvement in health-related quality of life

“…The ABG was calculated as the difference between the pure-tone average (PTA) of the air conduction (AC) PTA measured at 0.5, 1, 2, and 3 kHz (PTA 0.5-3 kHz ) and the respective bone conduction (BC) PTA. According to recommendations in hearing reporting standard [28] and to the Committee on Hearing Equilibrium guidelines [29], the ABG 0.5-3 kHz was chosen for evaluating the results of treating conductive hearing loss. Therefore, only the ABG 0.5-3 kHz was further analyzed and is referred to as ABG.…”

The effect of surgeon experience on tympanic membrane closure

“…Word recognition testing materials were not available in Ethiopia until late 2017 and therefore no Word Recognition Scores were obtained. Audiology outcome was recorded as the “change in extended pure tone average (PTA) (ePTA) of the air bone gaps (ABG)” which is the change (improvement) in the air bone gap in dB averaged over 500 Hz, 1 kHz, 2 kHz, and 4 kHz (ePTA) . This parameter of reporting is in accordance with the previous recommendation of AAO‐HNS Committee on Hearing and Equilibrium as described in 1995…”

“…Gurgel et al notes that many countries do not use word recognition testing, and therefore there is no data for one axis of the audiogram's scatterplot . In the cases of changes in conductive hearing loss, Gurgel et al advise the use of the change in PTA ABG model as described by the AAO‐HNS Committee on Hearing and Equilibrium . Therefore, change in the ePTA of the ABG represented as a “box‐and‐whiskers” graph (Fig.…”