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Our experience of ossiculoplasty in chronic otitis media and cholesteatoma

Presenting Author: Hao Wu

Published online by Cambridge University Press:  03 June 2016

Hao Wu ,
Jun Yang ,
Qi Huang ,
Zhaoyan Wang  and
Zhihua Zhang
Hao Wu
Affiliation:
Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine; Ear Institute, Shanghai Jiao Tong University School of Medicine
Jun Yang
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai, China
Qi Huang
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai, China
Zhaoyan Wang
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai, China
Zhihua Zhang
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Xinhua Hospital Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Ear Institute Shanghai Jiaotong University, Shanghai, China
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Abstract

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Learning Objectives:

Objectives: The aim of this study was to demonstrate our experience of ossiculoplasty using either partial osscicular replacement prosthesis(PORP) or total ossicular replacement prosthesis(TORP) in patients with chronic otitis media with or without cholesteatoma.

Methods: Five hundred seventy-three patients presenting chronic otitis media with or without cholesteatoma underwent ossiculoplasty from January 2001 to December 2014. A PORP is used when the stapes superstructure is intact. Conversely, a TORP is used if the superstructure is absent. The footplate of all patients was present and mobile. Audiometric results included ABG, closure of ABG, achievement of ABG ≤ 20 dB, and stability over time. The association between air-bone gain and age, ossiculoplasty material, preoperative diagnosis (chronic otitis media without cholesteatoma, cholesteatoma), and type of surgery (tympanoplasty, canal wall-down mastoidectomy, or canal wall-up mastoidectomy) was explored using regression analysis. Short-term results were analyzed within 6 months after surgery and long-term results were analyzed ≥ 12 months after surgery.

Results: There were 372 PORPs and 201 TORPs in our series. Overall, mean postoperative ABG was 18.5 dB at short-term and 21.7 dB at long-term follow-up (p > 0.05). And closure of ABG was 11 and 8 dB, respectively (p > 0.05). 74% of patients in PORP group and 56% of patients in TORP group achieved postoperative ABG ≤ 20 dB at 6 months after surgery. At long-term auditory follow-up (12 months), 71% of patients in PORP and 50% of patients in TORP group achieved postoperative ABG ≤ 20 dB. No significant differences in hearing results were found in different ossiculoplasty material.

Conclusion: Our results indicate that ossiculoplasty provide stable and excellent hearing improvement in patients with otitis media with or without cholesteatoma. Results with PORP was better than those with TORP.Several influential factors affected the outcomes of ossiculoplasty.