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Long-Term Hearing and Functional Outcomes and Complications after Ossiculoplasty

Presenting Author: John Dornhoffer

Published online by Cambridge University Press:  03 June 2016

John Dornhoffer  and
Matthew Cox
John Dornhoffer
Affiliation:
UAMS
Matthew Cox
Affiliation:
UAMS
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Abstract

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Learning Objectives: To study intermediate-term and long-term hearing results after ossiculoplasty and long-term goodness-of-fit for the ossiculoplasty outcomes parameter staging (OOPS) index.

Objective: To study intermediate-term and long-term hearing results after ossiculoplasty and long-term goodness-of-fit for the ossiculoplasty outcomes parameter staging (OOPS) index.

Patients: 417 patients (3-88 years of age; 258 adults and 159 children) undergoing ossiculoplasty with tympanoplasty or tympanomastoidectomy using cartilage tympanic membrane grafts, retrograde mastoidectomy with canal wall reconstruction or mastoid obliteration techniques between July 1998 and July 2012. All patients had at least 1 year of clinical follow-up. All patients had a minimum of 1 year of post-operative audiometric data and 185 (44.4%) patients (111 adults and 74 children) had ≥ 5 years of post-operative audiometric data.

Outcome Measures: Early (<1 year after surgery), intermediate-term (1–5 years after surgery) and long-term (>5 years after surgery) post-operative audiometric data.

Results: Hearing results were assessed in all patients with 1 year of longer of audiometric follow-up. Despite worse pre-operative hearing (average intermediate PTA-ABG was 30.2 dB vs. 32.3 dB, respectively; p = 0.0421), there was no significant difference between adults and children for early post-operative (average early post-op PTA-ABG [pure tone average air-bone gap] was 18.2 dB vs. 19.6 dB, respectively; p = 0.306), intermediate (average intermediate PTA-ABG was 18.4 dB vs. 19.7 dB, respectively; p = 0.235), or long-term hearing result (average final PTA-ABG was 18.6 dB vs. 19.4 dB, respectively; p = 0.439). There was a significant improvement from pre-op to post-op and long-term PTA-ABG for all comparisons (p <<< 0.01). Additionally, the rate of air-bone gap closure to less than 20 dB was not significantly different (63.1% vs. 58.0% for adults vs. children, respectively; p = 0.282).