Long-term Outcomes of Ossiculoplasty With and Without an Intact Malleus
| Autor: | Matthew D. Cox, Tristan Allsopp, Joshua Cody Page, John L. Dornhoffer, Deanne King |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Tympanic Membrane Adolescent Hearing loss medicine.medical_treatment Hearing Loss Conductive Young Adult Tympanoplasty Audiometry Long term outcomes Humans Medicine Malleus Postoperative Period Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Retrospective cohort study Middle Aged Prognosis Sensory Systems Surgery Treatment Outcome Otorhinolaryngology Referral center Female Tympanomastoidectomy Neurology (clinical) medicine.symptom business |
| Zdroj: | Otology & Neurotology. 40:73-78 |
| ISSN: | 1537-4505 1531-7129 |
| Popis: | Objective To compare long-term hearing outcomes following ossiculoplasty with cartilage tympanoplasty with (M) and without (M) the malleus present. Study design Retrospective chart review. Setting Tertiary referral center. Patients One twenty-six patients (18-88 yr of age) undergoing ossiculoplasty with tympanoplasty or tympanomastoidectomy using cartilage tympanic membrane grafts from 1998 to 2012 with at least 5 years of documented postoperative follow-up. Main outcome measures Short-term hearing results (pure-tone average air-bone gap [PTA-ABG] measured between 60 d and 1 yr after surgery), long-term hearing results (PTA-ABG measured ≥5 yr after surgery), Ossiculoplasty Outcome Parameter Staging (OOPS) index, and complications. Results There were 46 patients in the M group and 80 in the M group. Preoperative PTA-ABG was 23.8 dB for M and 34.5 dB for M (p = 0.00001). Short-term postoperative PTA-ABG was 19.3 dB for M and 18.5 dB for M (p = 0.727). Long-term postoperative PTA-ABG was 18.2 dB for M and 19.6 dB for M (p = 0.500). The OOPS index was 4.11 and 6.41 for M and M, respectively, (p = 0.00001). Thirteen patients (10.3%) experienced complications. Conclusion Our data suggest that the malleus is not statistically significant with regard to its impact on final audiometric outcome following ossiculoplasty. This has implications in our clinic, particularly in our use of the OOPS index as a prognostic tool, and will likely lead to its revision. These data may further support the coupling theory of acoustic gain and weaken the catenary lever theory. |
| Databáze: | OpenAIRE |
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