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TORP Ossiculoplasty Outcomes With and Without a Stapes Footplate Prosthesis

Presenting Author: Matthew Cox

Published online by Cambridge University Press:  03 June 2016

Matthew Cox ,
James Russell  and
John Dornhoffer
Matthew Cox
Affiliation:
University of Arkansas for Medical Sciences
James Russell
Affiliation:
University of Arkansas for Medical Sciences
John Dornhoffer
Affiliation:
University of Arkansas for Medical Sciences
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Abstract

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Learning Objectives: Compare hearing outcomes with and without the use of a footplate prosthesis as a method of optimizing ossicular coupling during TORP ossiculoplasty.

Objective: The titanium stapes footplate prosthesis (FPP) was designed to ensure a stable connection of a total sossicular replacement prosthesis (TORP) to the stapes footplate and optimize acoustic coupling by centering the footplate on the oval window. Our goal was to assess the impact of the FPP on TORP ossiculoplasty outcomes.

Study Design: Case series with chart review.

Setting: Tertiary care center.

Subjects: Adult patients undergoing TORP ossiculoplasty with (n = 53) or without (n = 108) a stapes FPP.

Methods: Rate of prosthesis displacement and audiologic outcomes were tabulated for statistical analysis.

Results: A lower rate of prosthesis displacement and statistically better audiologic outcomes were seen in FPP patients. The pure-tone average air-bone gap (PTA-ABG) was closed to ± 11.7 dB (standard deviation, SD) and 12.6 dB ± 11.0 dB (SD) in the study and control groups, respectively (p = 0.0012).

Conclusions: Use of the titanium stapes FPP during TORP ossiculoplasty provides a significant advantage in short-term PTA-ABG closure and a higher rate of successful rehabilitation of conductive hearing loss. Further studies are necessary to assess any long-term advantages a FPP may offer.