Stabilising total ossicular replacement prosthesis for ossiculoplasty with an absent malleus in canal wall down tympanomastoidectomy – a randomised controlled study

Babighian, G; Albu, Silviu

doi:10.1111/j.1749-4486.2011.02406.x

Cited by 13 publications

(11 citation statements)

References 21 publications

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“…Concerning the hearing outcome, the condition of the ossicles plays an important role, as reported by other authors [32,33,34,35,36]. In our study, the most important factor was an intact malleus.…”

Section: Discussionsupporting

confidence: 65%

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Audiometric Results of Open Cavity Tympanomastoidectomy in Advanced Attic Cholesteatoma

Minovi¹,

Dombrowski²,

Shahpasand³

et al. 2015

ORL

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In this retrospective study, we evaluated the audiometric results after using the retrograde mastoidectomy technique with open mastoid cavity for the removal of extended attic cholesteatomas. The described technique was used for cholesteatoma removal in 168 adult patients with an average follow-up time of 12 months. Due to cholesteatoma extension far into the mastoid, the disease was eradicated by the canal wall down (CWD) technique with the creation of an open mastoid cavity. Primary surgery was carried out in 47% of ears, with the remaining 53% representing revision surgery. In all cases, a classical CWD with an open mastoid cavity and partial obliteration with cartilage was created. A dry ear was achieved in 94% of cases. A postoperative air-bone gap ≤20 dB was achieved in 42.9% of the operated ears. 9.3% (n = 15) of the operated ears showed a postoperative air-bone gap >30 dB. Important factors leading to significantly better hearing restoration were an intact malleus, the use of alloplastic titanium prostheses and primary surgery. Although most cholesteatomas nowadays can be eradicated with the canal wall up technique, in far advanced cholesteatomas, the CWD technique can be applied with acceptable postoperative hearing results.

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Section: Discussionsupporting

confidence: 65%

“…The condition of the ossicular chain in chronic otitis media as a predictor of hearing outcome is discussed controversially in the literature [32,33,34,35,36]. Our data show that, in the majority of patients with advanced cholesteatomas, partial or complete ossicles are either missing or eroded.…”

Section: Discussionmentioning

confidence: 66%

Audiometric Results of Open Cavity Tympanomastoidectomy in Advanced Attic Cholesteatoma

Minovi¹,

Dombrowski²,

Shahpasand³

et al. 2015

ORL

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“…Babighian et al . [33] in their study of CWD TORP titanium OCR analysis for single frequencies showed the smallest postoperative airbone gap attainment at 2 kHz among all groups of patients. This could be related to the mass of prosthesis used as mass affects higher frequencies in hearing because of increasing ossicular inertia, which hampers the sound transfer mechanism [31].…”

Section: Discussionmentioning

confidence: 90%

Correlation of intraoperative middle ear status and hearing results in single-stage canal wall down tympanomastoidectomy with PORP—a prospective study

Tamang

Shakya

Pradhananga

et al. 2021

Egypt J Otolaryngol

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Background Mastoidectomy is one of the common surgical procedures performed by the otologist. It is commonly done for cholesteatomatous chronic otitis media (CCOM) and can be performed as either canal wall up or down techniques. Most of the CCOM is associated with ossicular erosions which require ossicular chain reconstruction (OCR) which can be done either in one stage or multiple stages. A multitude of factors affects postoperative OCR results with tympanomastoidectomy. Among various factors, the status of the tympanic membrane and middle ear mucosa is quite essential. To date, there are no randomized or prospective studies assessing the integrity of pars tensa and status of the middle ear mucosa in hearing outcomes in single-stage tympanomastoidectomy using partial ossicular replacement prosthesis (PORP) in the literature. Therefore, this study is performed to correlate the integrity of pars tensa and middle ear mucosa condition with postoperative hearing results of single-stage canal wall down (CWD) tympanomastoidectomy with PORP. Results Forty-two patients with cholesteatomatous chronic otitis media underwent single-stage canal wall down mastoidectomy (CWD) and partial ossicular replacement prosthesis (PORP) placement. The statistical analysis was done to compare the results of postoperative hearing with the intraoperative integrity of pars tensa and middle ear mucosa status. The mean pre- and postoperative air-bone gaps (ABGs) of all cases were 23.9 dB and 21 dB, respectively, with no statistically significant difference. In the pars tensa intact group, the mean pre- and postoperative ABGs were 21.5 dB and 18.5 dB, respectively, and in the pars tensa not intact group, the mean pre- and postoperative ABGs were 25.7 dB and 22.8 dB, respectively, and both groups had statistically insignificant difference. The pre- and postoperative ABGs in the healthy middle ear mucosa group were 20.7 dB and 19 dB, respectively. Similarly, the pre- and postoperative ABGs in non-healthy middle ear mucosa were 24.4 dB and 21.2 dB, respectively. The differences were not statistically significant in both groups. Conclusion There was a statistically significant improvement in postoperative air conduction threshold (ACT) in all cases. The integrity of pars tensa and middle ear mucosa status did not affect the postoperative hearing outcome in single-stage CWD tympanomastoidecomty using PORP.

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“…Achieving a postoperative ABG ≤20 dB is generally cited as success in ossiculoplasty . Overall, 84.1% of patients in group 1 and 75.2% of patients in group 2 attained a postoperative ABG of 20 dB or less.…”

Section: Resultsmentioning

confidence: 99%

Is it necessary to retain the tensor tympani tendon in tympanoplasty?

Deng

Tao

et al. 2015

The Laryngoscope

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Stabilising total ossicular replacement prosthesis for ossiculoplasty with an absent malleus in canal wall down tympanomastoidectomy – a randomised controlled study

Abstract: Better hearing outcomes for author's method could be demonstrated, but our sample size cannot exclude small and possible trivial, group differences.

Cited by 13 publications

References 21 publications

Audiometric Results of Open Cavity Tympanomastoidectomy in Advanced Attic Cholesteatoma

Audiometric Results of Open Cavity Tympanomastoidectomy in Advanced Attic Cholesteatoma

Correlation of intraoperative middle ear status and hearing results in single-stage canal wall down tympanomastoidectomy with PORP—a prospective study

Is it necessary to retain the tensor tympani tendon in tympanoplasty?

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