Long-term Complications and Surgical Failures After Ossiculoplasty

Cox, Matthew D.; Page, Joshua Cody; Trinidade, Aaron; Dornhoffer, John L.

doi:10.1097/mao.0000000000001572

Cited by 23 publications

(22 citation statements)

References 13 publications

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“…Although no material has been clearly demonstrated to yield better results than the others [9,12], a manufactured PORP and TORP are popular options for repairing the ossicular chain. Complications related to ossiculoplasty include the need for subsequent surgery, secondary ventilation tube insertion, displacement of the prosthesis, extensive scar tissue formation, and recurrence of perforation [13]. Tympanoplasty without ossiculoplasty may reduce complications and additional costs.…”

Section: Discussionmentioning

confidence: 99%

Is Ossiculoplasty Necessary in Canal Wall Down Mastoidectomy? Comparison of Clinical Outcomes Between Type 0 Tympanoplasty and Ossiculoplasty

Suh

Park

et al. 2021

J Audiol Otol

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Background and Objectives: To assess whether the audiological and clinical outcomes of type 0 tympanoplasty (T0) performed using cartilage were comparable with those of ossiculoplasty in patients who underwent canal wall down mastoidectomy (CWDM).Subjects and Methods: This study included patients who had chronic otitis media with cholesteatoma and underwent CWDM with ossiculoplasty involving partial ossicular replacement prosthesis (PORP), total ossicular replacement prosthesis (TORP), or T0. Anatomical success rates and hearing outcomes were analyzed.Results: Seventy-two patients were included in this study; 29 of them underwent CWDM with T0, 27 underwent CWDM with PORP, while 16 underwent CWDM with TORP. The difference in mean improvement in the air-bone gap (ABG) between the groups was not significant. The differences in the rates of ABG closure to ≤10 dB HL (p=0.030) and ≤20 dB HL (p=0.029) were significant. There were significant differences in improvements in the ABG at 3 kHz among the PORP, TORP, and T0 groups.Conclusions: The audiological outcomes of CWDM with ossiculoplasty seemed to be better than those of CWDM with T0 with no significant difference in the incidence of complications following ossiculoplasty and T0.

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Section: Discussionmentioning

confidence: 99%

Is Ossiculoplasty Necessary in Canal Wall Down Mastoidectomy? Comparison of Clinical Outcomes Between Type 0 Tympanoplasty and Ossiculoplasty

Suh

Park

et al. 2021

J Audiol Otol

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“…Worsening word recognition has been seen in patients in other series over long terms, but the reasons for this worsening have had limited discussion. 22,24 While it is difficult to determine the exact cause of this drop for individual patients, in all likelihood, this represents a progression of a sensorineural component of hearing loss present at the time of surgery. It is possible that manipulation of the oval window during surgery expedited this progression, although this cannot be proven definitively.…”

Section: Discussionmentioning

confidence: 99%

Long‐Term Hearing Outcomes following Total Ossicular Reconstruction with Titanium Prostheses

Wood

Yawn

Lowery

et al. 2019

Otolaryngol.--head neck surg.

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Objective (1) Characterize a large cohort of patients undergoing total ossicular chain reconstruction with titanium prosthesis. (2) Analyze long-term hearing outcomes of the same cohort. Study Design Case series with chart review. Setting Tertiary care center. Subject and Methods This study reviews patients who underwent total ossicular chain reconstruction (OCR) with titanium prostheses (TORPs) at a single tertiary care center from 2005 to 2015. Patient charts were reviewed for demographic data, diagnosis, and operative details. Patients were included in statistical analysis if length of follow-up was 2 years or more. Evaluation of hearing improvement was made by comparing preoperative air-bone gap (ABG) and ABG at follow-up at 2 years. Results In total, 153 patients were identified who met inclusion criteria. The mean age of included patients was 40 years (range, 6-89 years). Sixty patients (39%) had a history of OCR, and 120 patients (78%) had a diagnosis of cholesteatoma at the time of OCR. Preoperatively, the mean ABG was 36 ± 12, whereas the mean ABG at 2-year follow-up improved to 26 ± 13. This was statistically significant ( P < .0001) using a Wilcoxon matched-pairs signed rank test. Twelve patients (8%) required revision OCR. Two revisions were performed due to prosthesis extrusion (<1%). Conclusion Titanium prostheses lead to significant improvement in hearing over long periods. The results are sustained as far out as 5 years following surgery. In addition, rates of revision surgery with titanium TORPs are low. Based on this series, there are no readily identifiable predictors for outcomes following total OCR.

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“…12 This inconsistency is a reflection of the many variables likely to play a role in ossiculoplasty outcomes, including the underlying middleear pathology, the status of the Eustachian tube, surgical techniques, prostheses design, and patient factors. 4,[13][14][15][16][17][18][19][20][21] Furthermore, published data differ among studies with regard to the studied population, outcome measures reported, and follow-up periods. 22 Most agree, however, that careful patient selection is important in optimizing potential contributing factors and favoring ossiculoplasty outcomes.…”

Section: Discussionmentioning

confidence: 99%

Pilot Study Assessing the Feasibility and Clinical Outcomes of Office-Based Ossiculoplasty

Shoman

2018

Ann Otol Rhinol Laryngol

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The aim of this study was to assess the feasibility and safety of ossiculoplasty under local anesthesia in an office setting without sedation. Methods: Between May 2017 and November 2017, patients who presented with conductive hearing loss and known isolated ossicular discontinuities were offered ossiculoplasty under local anesthesia. Inclusion criteria included age ⩾ 18 years, adequate transcanal access, and the ability to lie supine for up to 45 minutes. Exclusion criteria included associated tympanic membrane perforation and the presence of middleear or mastoid cholesteatoma or infection. Results: Fourteen patients underwent the procedure. The mean age was 48.3 years (range, 19-74 years). Six were primary and 8 revision cases. There were 8 partial and 6 total prosthesis placements. The mean operative time was 34 minutes (range, 26-43 minutes). All patients tolerated the procedure to completion. There were no intraoperative complications. The mean air conduction pure-tone average was 76.6 dB and the mean bone conduction pure-tone average was 27.2 dB, with a preoperative air-bone gap of 49.9 dB. Air conduction pure-tone average significantly improved to 45.2 dB (P < .0001). Air-bone gap significantly improved to 17.8 dB (P < .0001). Conclusions: Ossiculoplasty using partial or total prostheses can be safely performed in the office setting under local anesthesia without sedation in carefully selected patients. This has potentially significant patient and system benefits.

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Long-term Complications and Surgical Failures After Ossiculoplasty

Cited by 23 publications

References 13 publications

Is Ossiculoplasty Necessary in Canal Wall Down Mastoidectomy? Comparison of Clinical Outcomes Between Type 0 Tympanoplasty and Ossiculoplasty

Is Ossiculoplasty Necessary in Canal Wall Down Mastoidectomy? Comparison of Clinical Outcomes Between Type 0 Tympanoplasty and Ossiculoplasty

Long‐Term Hearing Outcomes following Total Ossicular Reconstruction with Titanium Prostheses

Pilot Study Assessing the Feasibility and Clinical Outcomes of Office-Based Ossiculoplasty

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