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Pediatric cholesteatoma surgery : results of cartilage block ossiculoplasty

Presenting Author: Francoise Denoyelle

Published online by Cambridge University Press:  03 June 2016

Francoise Denoyelle ,
Jérome Nevoux ,
Pierre Chauvin  and
Noël Garabédian
Francoise Denoyelle
Affiliation:
Necker Children's Hospital, APHP and Paris Descartes University, Paris France
Jérome Nevoux
Affiliation:
Otolaryngology and Head and Neck Surgery Department, Bicêtre Hospital and Paris XI University
Pierre Chauvin
Affiliation:
Department of Public Health, Saint Antoine Hospital, Paris VI University
Noël Garabédian
Affiliation:
Pediatric Otolaryngology and Head and Neck Surgery Department, Necker Children's Hospital, APHP and Paris Descartes University, Paris France
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Abstract

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Information
The Journal of Laryngology & Otology , Volume 130 , Supplement S3: Abstracts for the 10th International Conference on Cholesteatoma , May 2016 , pp. S162 - S163
Copyright
Copyright © JLO (1984) Limited 2016 

Learning Objectives: To assess the efficacy and long-term stability of partial ossicular chain reconstruction using autologous cartilage.

Objective: To assess the efficacy of partial ossicular chain reconstruction using autologous cartilage.

Design and setting: Retrospective study, Tertiary academic children's hospital.

Patients: Two hundred forty-eight children (268 ears) underwent partial ossicular chain reconstruction using a shaped block of tragal cartilage interposed between the head of the stapes and an underlay tympanic membrane reconstruction along with tragal cartilage and its perichondrium.

Main Outcome Measures: Anatomical and audiologic results were evaluated according to the American Academy of Otolaryngology–Head and Neck Surgery guidelines. X2 Tests and multivariate analysis were used for statistical evaluation.

Results: Mean age at surgery was 10.9 years. Single stage surgery was performed in 124 ears (46.3%) (62.9% for cholesteatomas and 32.3% for retraction pockets). Second-look patients (53.7%) included 93.8% of staged surgery. Audiometric results were available for 222 ears at 1 year and for 78 ears at 5 years. Closure of the average air-bone gap (ABG) to within 20 dB was achieved in 62.2% of ears at 1 year. The mean (SD) preoperative and 1-year postoperative ABGs were 25 (11.8) dB and 18.9 (10.3) dB, respectively. Anatomical results were satisfactory in 87.3%. No cases of extrusion, resorption, or displacement of the cartilage were encountered. No statistically significant difference was found between audiometric results at 1 and 5 years. Multivariate analysis showed a significant negative correlation between preoperative and postoperative ABGs and between postoperative otitis media with effusion and postoperative ABG (P_.05).

Conclusions: Cartilage block ossiculoplasty is a reliable technique for partial ossicular replacement. Long-term hearing outcomes remain stable and satisfactory. Preoperative ABG and postoperative otitis media are the predictive factors of the hearing outcome.