Hearing Outcomes after Revision Stapedectomy Managed with Total Ossicular Prostheses.

Autor: Lupo JE; House Ear Clinic, University of Southern California Keck School of Medicine, Los Angeles, California, USA., Strickland BM; University of Southern California Keck School of Medicine, Los Angeles, California, USA., House JW; House Ear Clinic, University of Southern California Keck School of Medicine, Los Angeles, California, USA University of Southern California Keck School of Medicine, Los Angeles, California, USA jhouse@houseclinic.com.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2015 Dec; Vol. 153 (6), pp. 1013-8. Date of Electronic Publication: 2015 Jul 16.
DOI: 10.1177/0194599815593741
Abstrakt: Objectives: (1) To describe the use of total ossicular prostheses (TOPs) in the setting of stapedectomy requiring an incus bypass procedure. (2) To analyze the short- and long-term audiometric results of TOP utilization in the setting of stapedectomy for an incus bypass procedure.
Study Design: Case series with chart review.
Setting: Tertiary neurotologic referral center.
Subjects and Methods: Seventeen cases of TOP reconstruction after stapedectomy were performed due to advanced incus erosion. The cases were assessed for pre- and postoperative bone conduction and air conduction pure-tone averages (PTAs; 0.5, 1, 2, 3 kHz), including high-tone bone conduction (1, 2, 4 kHz), air-bone gap, and speech discrimination scores. Hearing outcomes were measured: short-term (3 weeks) and long-term (average, 22 months).
Results: Among 17 ears undergoing revision stapedectomy managed with TOP reconstruction, the average number of previous revision attempts was 1.0 (SD, 1; range, 1-5). The preoperative bone conduction PTA was 30.7 dB preoperatively, while the preoperative air conduction PTA was 64.3 dB. The mean postoperative air-bone gap significantly decreased to 18.9 dB (SD, 12.7; range, 5-46.25; P < .003) with a mean follow-up of 22.2 months (SD, 25.0; range, 0.75-78). No significant decrement in high-tone bone conduction PTA was observed (mean, 0 dB; SD, 12.8; range, -36.7 to 20; P = .427); however, 1 ear revealed a severe decrease in PTA and speech discrimination score postoperatively. No further revisions were noted in follow-up.
Conclusion: TOP reconstruction in the setting of previous revision stapedectomy with limited incudovestibular reconstructive options may lead to favorable hearing outcomes, but it carries an increased risk of sensorineural hearing loss.
(© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.)
Databáze: MEDLINE
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