Ossiculoplasty: study of hearing results in 50 patients
Keywords:Ossiculoplasty, Hearing, Autograft
Background: Ossiculoplasty improves conductive hearing loss. Various reconstruction methods and techniques are developed with use of different graft materials over period of time. Results of ossiculoplasty can be predetermined with consideration of prognostic factors.
Methods: The present study is retrospective study of 50 patients who underwent ossiculoplasty in the medical college hospital over the period of 3 years i.e. from January 2013 to December 2016. The pre-operative and post-operative audiometric findings were documented and analyzed to study the hearing improvement with the use of auto graft malleus and incus for ossiculoplasty. The results of ossiculoplasty were also compared with other studies done for ossiculoplasty. Predictors of ossiculoplasty results such as ossicular status and middle ear mucosa were also studied.
Results: The average post-operative air bone gap was 12.92 dB. The mean post-operative ABG was within 20 dB in both primary and revision cases. Average air-bone closure in patients with normal mucosa was 32.1 dB and that of adhesive mucosa was 18 dB. Significant improvement in post-operative air-bone closure (p <0.01) was observed in patients with auto graft incus than malleus head as ossiculoplast.
Conclusions: 84% ossiculopasty patients were having post-operative air bone gap within 20 dB. The ossiculoplasty using auto graft ossicle is physiological, biocompatible, stable and has low complication rate.
Albera R, Canale A, Piumetto E, Lacilla M, Dagna F. Ossicular chain lesions in cholesteatoma. Acta otorhinolaryngologica Italica: organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale. 2012;32(5):309–13.
2. Mostafa BE, Fiky LE, Hassan O. Functional results in ossiculoplasty with different titanium prostheses. Egyptian J Ear, Nose, Throat Alli Sci. 2013;14(2):79–84.
Zollner F. The principles of plastic surgery of the sound conducting apparatus. J Laryng. 1955;69:637.
Nikolaou A, Bourikas Z, Maltas V, Aidonis A. Ossiculoplasty with the use of autografts and synthetic prosthetic materials: a comparison of results in 165 cases. J Laryngol Otol. 1992;106(8):692-4.
Zheng C, Guyot JP, Montandon P. Ossiculoplasty by interposition of a minor columella between the tympanic membrane and stapes head. Am J Otol. 1996;17(2):200-2.
Chavan SS, Jain PV, Vedi JN, Rai DK, Kadri H. Ossiculoplasty: A Prospective Study of 80 Cases. Iran J Otorhinolaryngol. 2014;26(76):143–50.
O'Reilly RC, Cass SP, Hirsch BE, Kamerer DB, Bernat RA, Poznanovic SP. Ossiculoplasty Using Incus Interposition: Hearing Results and Analysis of the Middle Ear risk Index. Otol Neurotol. 2005;26:853–8.
Mishiro Y, Sakagami M, Kitahara T, Kakutani C. Prognostic factors of long-term outcomes after ossiculoplasty using multivariate analysis. Eur Arch Otorhinolaryngol. 2010;267(6):861-5.
Iurato S, Marioni G, Onofri M. Hearing Results of Ossiculoplasty in Austin-Kartush Group A Patients. Otol & Neurotol. 2001;22:140–4.
Naderpour M, Jabbari-Moghaddam Y, Radfar R, Zarrintan S, Pourfathi H. Results of single stage ossicular reconstruction by incus transposition in patients with chronic otitis media. Rawal Med J. 2007;32(2):179-83.
Ceccato SB, Maunsell R, Morata GC, Portmann D. Comparative results of type II ossiculoplasty: incus transposition versus titanium PORP (Kurz)]. Rev Laryngol Otol Rhinol (Bord). 2005;126(3):175-9.
JB Farrior, Nichols SW. Long-term results using ossicular grafts. Am J Otol. 1996;17(3):386-92.
Naragund AI. Ossiculoplasty with autologous incus versus titanium prosthesis:A comparison of anatomical and functional results. Indian J Otolaryngol. 2011;17:2-75.
Mishiro Y, Sakagami M, Adachi O, Kakutani C. Prognostic Factors for Short-term Outcomes After Ossiculoplasty Using Multivariate Analysis With Logistic Regression. Arch Otolaryngol Head Neck Surg. 2009;135(8):738-41.
Dornhoffer JL, Gardner E. Prognostic factors in ossiculoplasty: a statistical staging system. Otol Neurotol. 2001;22:299-304.
Yung M, Vowler SL. Long-Term Results in Ossiculoplasty: An Analysis of Prognostic Factors. Otol & Neurotol. 2006;27:874-81.
Browning GG, Merchant S, Kelly G. Chronic otitis media. Scott brown’s Otolaryngology and Head and Neck surgery. Volume 3. 7th edition. London: Edward Arnold; 2008: 3399.