Ossiculoplasty in chronic otitis media: Surgical results and prognostic factors of surgical success

Sousa, Ana Castro; Henriques, Vânia; Rodrigues, Jorge; Fonseca, Rui

doi:10.1016/j.otorri.2016.06.006

Cited by 22 publications

(5 citation statements)

References 12 publications

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“…The immediate improvement in hearing is the aim with TPL type III in chronically infected ears without cholesteatoma. Nevertheless, the ABG-closure is lower than that reported in other studies [ 11 , 18 , 19 ]. This is mainly attributable to the early postoperative time of measurement as mentioned above.…”

Section: Discussioncontrasting

confidence: 78%

“…Many factors described in the literature allow the prediction of overall hearing improvement after ossiculoplasty and tympanoplasty: surgery-related factors, such as the type of middle ear implant [ 5 ], sequential or non-sequential surgery [ 6 ], and status of the posterior canal wall [ 7 ]; disease-related aspects, such as the presence of cholesteatoma [ 8 ], mucosa status [ 9 ], the presence of the malleus handle [ 9 , 10 ], and the presence of the stapes supra-structure [ 11 ]. Unidentified factors probably also influence outcome.…”

Section: Introductionmentioning

confidence: 99%

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Hearing outcome after tympanoplasty type III

Tihanyi

Speck

Wolff

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose We assessed overall hearing outcome after tympanoplasty type III in chronically infected ears with cholesteatoma (CH) and without cholesteatoma: otitis media chronica mesotympanalis, tympanosclerosis, and adhesive process (COM_T_AP). Methods 303 surgeries were evaluated: 229 CH-group and 74 COM_T_AP-group. Air-bone gaps (PTA-ABG) with pure-tone averages (PTA-4) at four frequencies (0.5, 1, 2 and 4 kHz) were compared preoperatively, early postoperatively (< 40 days) and late postoperatively (40–400 days). Hearing outcome was compared in various types of middle-ear reconstruction and in smokers and non-smokers. Correlations between hearing outcome and predictive staging indices were evaluated: Middle Ear Risk-Index (MER-I) and Ossiculoplasty Outcome Parameter Staging-Index (OOPS-I). Results Mean PTA-ABG in the CH-group increased from 20.9 ± 11.3 dB to 22.3 ± 10.4 dB early postoperatively and decreased significantly to 19.2 ± 10.1 dB late postoperatively. Mean PTA-ABG in the COM_T_AP-group decreased significantly from 27.3 ± 10.9 dB to 20.6 ± 10.9 dB early postoperatively and decreased to 20.0 ± 12.2 dB late postoperatively. No significant difference was seen between PTA-ABG-closures of partial or total ossicular replacement prosthesis (PORP/TORP) and cartilage ossiculoplasty in the CH-group. Patients receiving TORP showed a significantly higher preoperative PTA-ABG. All reconstruction types exhibited postoperative PTA-ABG around 20 dB. In the COM_T_AP-group, smokers had a significantly higher mean PTA-ABG early postoperatively; this equalized with that of non-smokers late postoperatively. PTA-ABG-closures and MER-I or OOPS-I were not significantly correlated. Conclusion Tympanoplasty type III maintains hearing in patients with cholesteatoma and significantly improves hearing in chronically inflamed ears without cholesteatoma. All investigated ossicular replacement prostheses are equally beneficial. Healing postoperatively takes longer in smokers, but they eventually catch up with non-smokers.

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Section: Discussioncontrasting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Hearing outcome after tympanoplasty type III

Tihanyi

Speck

Wolff

et al. 2022

Eur Arch Otorhinolaryngol

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“…Some studies reported that stapes conditions, such as the loss of the superstructure, could worsen postoperative ABG. 56,64 Second, the number of patients was relatively small, and the number of variables was relatively large. However, despite the relatively small cohort, the superiority of machine learning techniques compared with conventional methods was verified.…”

Section: Discussionmentioning

confidence: 99%

Application of Machine Learning to Predict Hearing Outcomes of Tympanoplasty

et al. 2022

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ObjectiveThis retrospective study aimed to evaluate the performance of machine learning techniques in predicting air‐bone gap after tympanoplasty compared with conventional scoring models and to identify the influential factors.MethodsWe reviewed the charts of 105 patients (114 ears) with chronic otitis media who underwent tympanoplasty. Two numerical scoring systems (middle ear risk index [MERI] and ossiculoplasty outcome parameter staging [OOPS]) and three algorithms (random forest [RF], support vector machine [SVM], and k nearest neighbor [kNN]) were created. Experimental variables included age, preoperative air‐bone gap, soft‐tissue density lesion in the tympanic cavity in CT, otorrhea, surgical history, ossicular bone problems in CT, tympanic perforation location, perforation type (central or marginal), grafting material, smoking history, endoscopy use, and the operator whose experience was 20 years or longer, or shorter. Binary classification, postoperative air‐bone gap ≤15 or >15 dB, and multiclass classification, classification into seven categories by 10 dB, were performed, and the percentages of correct prediction were calculated. The importance of features in the RF model was calculated to identify influential factors.ResultsThe percentages of correct prediction in binary classification were 62.3%, 72.8%, 81.5%, 81.5%, and 81.5% in MERI, OOPS, RF, SVM, and kNN, respectively, and those in multiclass classification were 29.8%, 21.9%, 63.1%, 44.7%, and 50% in the same order. The RF model suggested larger preoperative air‐bone gap, and older age could make the postoperative air‐bone gap larger.ConclusionThe machine learning techniques, especially the RF model, are promising methods for precise postoperative air‐bone gap prediction.Level of Evidence4 Laryngoscope, 133:2371–2378, 2023

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“…5 Moreover, the integrity of the middle ear mucosa and the stapes superstructure were significant predictors of surgical success in patients with COM who received ossiculoplasty. 6 However, the efficacy of different materials used, such as ossicular autografts or titanium prosthesis, and the predictive factors of hearing improvement remain unclear in patients with traumatic ossicular injury.…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors and Audiometric Outcome Comparison Between Titanium Prosthesis and Autologous Incus in Traumatic Ossicular Injury

Chien

Tai

Chan

et al. 2023

Ann Otol Rhinol Laryngol

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Objectives: To investigate the etiology and ossicular pathology of traumatic ossicular injury in Taiwan and examine the hearing outcomes and predictive factors between the titanium prosthesis and autologous incus groups. Methods: We retrospectively analyzed patients with traumatic ossicular injury from 2011 to 2020 in Taiwan. Patients were divided into the titanium or autologous group according to the surgical materials used. The audiometric outcomes and predictive factors of ossiculoplasty were analyzed between groups. Results: Twenty patients with ossicular chain discontinuity were enrolled (8 in the titanium group and 12 in the autologous group). The postoperative hearing threshold (26.6 ± 8.9 dB) and air-bone gap (10.3 ± 5.6 dB) improved significantly compared with the preoperative hearing threshold (50.7 ± 13.3 dB) and air-bone gap (29.9 ± 11.0 dB). The improvements in the hearing threshold and air-bone gap were not significantly different between the titanium and autologous groups. Our patients presented an improvement in hearing restoration with 65% closure of the air-bone gap in 0 to 10 dB range and 30% in 11 to 20 dB range, without sensorineural hearing loss during surgery. Univariate regression analysis revealed that vertigo, benign paroxysmal positional vertigo, and temporal bone fracture may serve as negative factors influencing the air-bone gap gain. Conclusions: Ossiculoplasty with both titanium prosthesis and autologous materials demonstrated favorable hearing recovery in traumatic ossicular injury. Vertigo, benign paroxysmal positional vertigo, and temporal bone fracture may serve as negative predictive factors of the hearing benefit after surgery.

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Ossiculoplasty in chronic otitis media: Surgical results and prognostic factors of surgical success

Cited by 22 publications

References 12 publications

Hearing outcome after tympanoplasty type III

Hearing outcome after tympanoplasty type III

Application of Machine Learning to Predict Hearing Outcomes of Tympanoplasty

Predictive Factors and Audiometric Outcome Comparison Between Titanium Prosthesis and Autologous Incus in Traumatic Ossicular Injury

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