Long‐term Outcomes of Titanium Ossiculoplasty in Chronic Otitis Media

O’Connell, Brendan P.; Rizk, Habib G.; Hutchinson, Tanisha; Nguyen, Shaun A.; Lambert, Paul R.

doi:10.1177/0194599816633669

Cited by 42 publications

(38 citation statements)

References 36 publications

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“…This is comparable to similar follow‐up investigations . The patients in this study achieved an ABG of less than 20 dB, which is a common goal for successful hearing improvement …”

Section: Discussionsupporting

confidence: 87%

“…For ossiculoplasty with a PORP, recently published studies have reported various mean improvements in ABG, including 8.9 dB (standard deviation [SD] 10.3 dB; n = 47), 10 13 dB (SD 13 dB; n = 44), 11 and 14.2 dB (SD 15.3 dB; n = 52). 12 In the present study population, the ABG improved by 8.5 dB (n = 141), which is slightly lower compared to other studies. This improvement is at the lower end of the published ABG scales and may be due to the comparatively small ABG preoperatively (22.5 dB) in our study group.…”

Section: Discussioncontrasting

confidence: 78%

“…10 The patients in this study achieved an ABG of less than 20 dB, which is a common goal for successful hearing improvement. [10][11][12] There are several factors under discussion that influence the audiological outcome of middle ear surgery. The underlying middle ear disease, 7,13 status of the malleus handle, 7,14-17 ventilation and mucosa of the middle ear, 7,17 presence of the stapes suprastructure, 7,13,14,17 surgical technique (e.g., canal wall up [CWU] vs. canal wall down [CWD]), 14,15,18 reconstruction material, 14,19,20 surgeon's experience, 15 and number of previous ear surgeries 16 seem to play a role in the outcome of surgery.…”

Section: Discussionmentioning

confidence: 99%

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

Weiss

Großmann

et al. 2019

The Laryngoscope

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Objectives To compare the results of ossiculoplasty with two different partial ossicular replacement prostheses (PORP) to ossiculoplasty with a total ossicular replacement prosthesis (TORP) in patients with an intact stapes suprastructure. Methods All patients required primary or revision surgery for chronic middle ear disease and ossicular reconstruction with either a PORP or a TORP, as well as a with an intact stapes suprastructure. In total, 141 patients receiving classic tympanoplasty with PORP (N = 92), ossiculoplasty with PORP with ball joint (N = 22), or TORP (N = 27) between January 2011 and March 2017 were included in this study. The inclusion criterion was an intact stapes suprastructure. The underlying indication for surgery was either middle ear disease, such as cholesteatoma, or revision surgery for audiological improvement. The main outcome measures were four‐frequency pure tone average (0.5, 1, 2, 3 kHz) at early and late follow‐up after ossiculoplasty, the effects of clinical factors including the underlying middle ear disease, and primary or revision surgery. Results All patients showed a significantly reduced air‐bone gap (ABG 0.5, 1, 2, 3 kHz) at late follow‐up (mean: 18 dB) compared to preoperative measurements (mean: 25.5 dB). A significantly better outcome in ABG closure was shown among patients with a preoperatively intact tympanic membrane, with an intact stapes suprastructure or without preexisting cholesteatoma. Outcome was not significantly influenced by the prosthesis‐type, the creation of an open mastoid cavity, the status of the mucosa, or the indication for surgery. Conclusion TORP with an intact stapes suprastructure is a safe procedure and provides audiological outcomes similar to PORP. Level of Evidence 2C Laryngoscope, 130:768–775, 2020

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“…This is comparable to similar follow‐up investigations . The patients in this study achieved an ABG of less than 20 dB, which is a common goal for successful hearing improvement …”

Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Weiss

Großmann

et al. 2019

The Laryngoscope

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“…PORP results showed a better success and hearing outcome than TORP, which could be explained by poor stability and inadequate coupling at the TORP–footplate interface of the prosthesis, but it was statically insignificant, which is agreed with other studies …”

Section: Discussionsupporting

confidence: 90%

The benefit of trans‐attic endoscopic control of ossicular prosthesis after cholesteatoma surgery

et al. 2019

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Objective To show the efficiency of using transmastoid atticotomy (TMA) endoscopy on the outcome of ossiculoplasty in patients with cholesteatoma. TMA is often performed as part of the surgical management of patients with middle ear cholesteatoma extending to the epitympanum. TMA can also be used as an access for endoscopic view to confirm the right alignment and stability of the ossicular prosthesis because the reconstruction of the tympanic membrane will obscure the visualization of the prosthesis. Methods A retrospective study was done at a tertiary referral institute, including 133 ears with cholesteatoma that underwent canal wall‐up tympanomastoidectomy (CWU) with ossicular reconstruction using titanium prosthesis between August 2013 and August 2015. Post packing of the ear canal and position, stability, and axis of the prosthesis were checked using endoscope positioned in the attic through TMA. A postoperative pure‐tone average air–bone gap (ABG) of 20 dB or less was considered as a successful hearing result. Results are compared with historical control groups. Results Of the 133 ears, 88 patients underwent reconstruction with partial ossicular replacement prosthesis (PORP), whereas the rest (45 patients) had total ossicular replacement prosthesis (TORP). A postoperative ABG ≤ 20 dB was obtained in 77.4% of all the patients (79.5% for PORP; 73.3% for TORP). Conclusion Endoscopic assessment of the ossicular prosthesis via the attic, after repositioning of the tympanomeatal flap and packing the ear canal, decreases the risk of immediate ossiculoplasty failure and improves the functional outcome after ossicular chain reconstruction in cholesteatoma surgery. Level of Evidence 4 Laryngoscope, 129:2754–2759, 2019

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“…Among these materials, none has clearly demonstrated its superiority over the others. According to the literature, closure of the ABG to within 20 dB ranges from 60% to 85% with incus interposition [12][13][14] , from 57% to 84% with hydroxyapatite [11] , and from 60% to 81% with titanium [15][16][17][18] . Most papers comparing hearing outcomes of various ossiculoplasty materials have come to similar conclusions [19][20][21][22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma

Denis¹,

Manac'h²,

Teszler³

et al. 2017

Int Adv Otol

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Original Article INTRODUCTIONThe double cartilage block ossiculoplasty for partial ossicular reconstruction in the presence of an intact stapes was described in 1987 by Luetje and Denninghoff [1] . This technique offers several advantages-it is easy to perform, uses well-tolerated autologous materials, and has no additional cost. Despite those advantages and encouraging hearing results, this interesting ossiculoplasty technique is not very popular among otologists.For several years we have routinely used this technique at our institution, and we commonly refer to it as cartilage ossiculoplasty from stapes to tympanic membrane (COST). We decided to evaluate our results with this technique in a retrospective case-control study and to compare these to results published in studies dealing with other partial ossicular chain reconstruction techniques.To obtain a homogenous series, we selected patients having undergone a COST during a one-stage intact canal wall tympanoplasty (ICW) for cholesteatoma, even if this condition is probably one of the worst for achieving good hearing results. MATERIALS and METHODSAmong all surgical procedures performed at our institution for chronic otitis media between January 1999 and August 2006, we retrospectively selected the files of patients having undergone a COST during a primary one-stage ICW for middle ear and/or mastoid acquired cholesteatoma. We excluded ossiculoplasty procedures performed in case of chronic otitis media without cholesteatoma, canal wall-down tympanoplasties (CWD), ICW with staged ossiculoplasty, ossiculoplasties performed with other material than cartilage (incus, malleus head, hydroxyapatite, or titanium prosthesis), and cases where the stapes superstructure was missing. ICW included transcanal removal of a middle ear cholesteatoma and canal wall-up tympanoplasty.Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma OBJECTIVE: To report hearing results of cartilage interposition ossiculoplasty in one-stage intact canal wall (ICW) tympanoplasty for cholesteatoma with intact stapes. MATERIALS and METHODS:A retrospective study of pre and postoperative hearing status was conducted at a tertiary referral otologic center in a series of 61 patients having undergone one-stage ICW tympanoplasty for cholesteatoma with intact stapes and cartilage ossiculoplasty during the same procedure. RESULTS:In the preoperative period, the mean air conduction thresholds (AC), air-bone gap (ABG), and speech reception thresholds (SRT) were 35.3, 20.14, and 35.6 dB, respectively. Postoperatively, with a mean follow-up of 29 months, AC, ABG, and SRT were 27.8, 13.34, and 28.8 dB, respectively. Mean hearing gain was 6.8 dB and mean SRT improvement was 6.8 dB. Mean bone conduction thresholds for 1, 2, and 4 kHz remained stable after surgery (17.6 dB preoperatively vs. 18 dB postoperatively). CONCLUSION:Cartilage ossiculoplasty from stapes to tympanic membrane in one-stage ICW tympanoplasty for cholesteatoma is a safe, relia...

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Long‐term Outcomes of Titanium Ossiculoplasty in Chronic Otitis Media

Abstract: With a minimum follow-up of 2 years, titanium ossiculoplasty provides good long-term hearing results. Modest deterioration in hearing is noted over time.

Cited by 42 publications

References 36 publications

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

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

The benefit of trans‐attic endoscopic control of ossicular prosthesis after cholesteatoma surgery

Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma

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