Long-Term Hearing Results After Ossiculoplasty

Cox, Matthew D.; Trinidade, Aaron; Russell, James S.; Dornhoffer, John L.

doi:10.1097/mao.0000000000001339

Cited by 25 publications

(24 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies regarding cholesteatoma surgery were heterogenous and included both CWU and CWD mastoidectomies, 12,16-20 primary and revision procedures, 19,20 and pediatric and adult populations. 19-21 Moreover, ossiculoplasty comparison in this group of patients as a single-stage procedure after tympanomastoidectomy has yet to be discussed in the literature.…”

Section: Introductionsupporting

confidence: 92%

Tympanomastoidectomy for Cholesteatoma in Children: Audiometric Results

Tzelnick

Yaniv

Raveh

et al. 2019

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

Objectives: The aim of this study was to investigate the audiometric outcomes of tympanomastoidectomy in children with cholesteatoma and to evaluate factors that may affect outcomes. Methods: A retrospective cohort study was conducted. All pediatric patients diagnosed with cholesteatoma who underwent primary canal wall-up tympanomastoidectomy with or without ossicular reconstruction from 2009 to 2016 at a tertiary university-affiliated pediatric medical center were included. Pure tone average (PTA) and air-bone gap (ABG) at 0.5, 1, 2, and 4 kHz were compared before and after surgery. Results: The cohort included 100 children (104 tympanomastoidectomies) of mean age 10.35 ± 3.6 years. The mean duration of follow-up was 35.4 ± 24.1 months. At surgery, 22 patients (21.2%) had intact ossicular chains, and 82 (78.8%) had ossicular discontinuity. Fifty-three patients (51%) underwent ossicular reconstruction, either partial (34 patients [64.1%]) or total (19 patients [35.8%]). In comparison with preoperative audiometry, there was a statistically significant improvement in PTA-ABG at the first postoperative examination (27.5 ± 12.7 vs 21.1 ± 11.1 dB, P = .001) and at the end of follow-up (20.2 ± 12.7 dB, P = .003) . Overall, values of less than 20 dB were measured in 34% of patients preoperatively and 73% postoperatively. On subgroup analysis, in patients who underwent any ossicular reconstruction, PTA-ABG was significantly improved relative to the preoperative value (28.1 ± 14.7 dB) at both the first (19.1 ± 11.9 dB, P = .006) and last (22.4 ± 15.1 dB, P = .011) audiometry examinations. Conclusions: Hearing outcomes after pediatric cholesteatoma surgery are diverse and related to several factors. The authors found that ossicular reconstruction improves audiometric outcomes, and the changes remain stable over time. Level of Evidence: IIB

show abstract

Section: Introductionsupporting

confidence: 92%

Tympanomastoidectomy for Cholesteatoma in Children: Audiometric Results

Tzelnick

Yaniv

Raveh

et al. 2019

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

show abstract

“…Short-term and long-term ossiculoplasty results however can vary significantly [Yu et al, 2013], and poor long-term results are caused by various factors with extrusion and displacement being most common. Moreover, patients who underwent ossiculoplasty very often require a conventional hearing aid (cHA) even after surgery [Cox et al, 2017;De la Cruz and Teufert, 2003]. The additional use of cHAs may be suitable to treat the sensorineural component of the hearing loss.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Vibroplasty Coupler Implantations to Treat Mixed/Conductive Hearing Loss

et al. 2018

View full text Add to dashboard Cite

Objective: To evaluate the long-term safety and performance of four different vibroplasty couplers (round window, oval window, CliP and Bell coupler) in combination with an active middle ear implant. Methods: This was a multicentre, prospective, long-term study including 5 German hospitals. Thirty adult subjects suffering from conductive or mixed hearing loss were initially enrolled for the study, 24 of these were included in the final analysis with up to 36 months of postsurgical follow-up data. Bone conduction and air conduction were measured pre- and postoperatively to evalu ate safety. Postoperative aided sound field thresholds and Freiburger monosyllable word recognition scores were compared to unaided pre-implantation results to confirm performance. Additional speech tests compared postoperative unaided with aided results. To determine patient satisfaction, an established quality-of-life questionnaire developed for conventional hearing aid usage was administered to all subjects. Results: Mean postoperative bone conduction thresholds remained stable throughout the whole study period. Mean functional gain for all couplers investigated was 38.5 ± 11.4 dB HL (12 months) and 38.8 ± 12.5 dB HL (36 months). Mean word recognition scores at 65 dB SPL increased from 2.9% in the unaided by 64.2% to 67.1% in the aided situation. The mean postoperative speech reception in quiet (or 50% understanding of words in sentences) shows a speech intelligibility improvement at 36 months of 17.8 ± 12.4 dB SPL over the unaided condition. The signal-to-noise ratio (SNR) improved by 5.9 ± 7.2 dB SNR over the unaided condition. High subjective device satisfaction was reflected by the International Inventory for Hearing Aids scored very positively. Conclusion: A significant improvement was seen with all couplers, and audiological performance did not significantly differ between 12 and 36 months after surgery.

show abstract

“…12,13 The overall success rate for ossiculoplasty at threshold for success <20 db HL was lower than most other studies have reported. 14,15 We speculate that this may be because we based success on a postoperative audiogram done 3 months postoperatively, which was earlier than most other studies have reported, as audiograms 1 year after surgery were often not available to us, and this finding may reflect persistent middle ear effusion postoperatively. There was also a large number of patients in our study who had undergone previous surgeries, which may predispose to ossiculoplasty failure due to damage to stapes and oval window structures from surgery or disease as well chronic changes of the middle ear spaces from long-term chronic otitis media and cholesteatoma.…”

Section: Discussionmentioning

confidence: 93%