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Comparison of total and partial ossicular replacement prostheses in patients with an intact stapes suprastructure
Author(s) -
Weiss Nora M.,
DO Ha Vy,
Großmann Wilma,
Oberhoffner Tobias,
Schraven Sebastian P.,
Mlynski Robert A.
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28060
Subject(s) - stapes , medicine , prosthesis , tympanoplasty , cholesteatoma , middle ear , surgery
Objectives To compare the results of ossiculoplasty with two different partial ossicular replacement prostheses (PORP) to ossiculoplasty with a total ossicular replacement prosthesis (TORP) in patients with an intact stapes suprastructure. Methods All patients required primary or revision surgery for chronic middle ear disease and ossicular reconstruction with either a PORP or a TORP, as well as a with an intact stapes suprastructure. In total, 141 patients receiving classic tympanoplasty with PORP (N = 92), ossiculoplasty with PORP with ball joint (N = 22), or TORP (N = 27) between January 2011 and March 2017 were included in this study. The inclusion criterion was an intact stapes suprastructure. The underlying indication for surgery was either middle ear disease, such as cholesteatoma, or revision surgery for audiological improvement. The main outcome measures were four‐frequency pure tone average (0.5, 1, 2, 3 kHz) at early and late follow‐up after ossiculoplasty, the effects of clinical factors including the underlying middle ear disease, and primary or revision surgery. Results All patients showed a significantly reduced air‐bone gap (ABG 0.5, 1, 2, 3 kHz) at late follow‐up (mean: 18 dB) compared to preoperative measurements (mean: 25.5 dB). A significantly better outcome in ABG closure was shown among patients with a preoperatively intact tympanic membrane, with an intact stapes suprastructure or without preexisting cholesteatoma. Outcome was not significantly influenced by the prosthesis‐type, the creation of an open mastoid cavity, the status of the mucosa, or the indication for surgery. Conclusion TORP with an intact stapes suprastructure is a safe procedure and provides audiological outcomes similar to PORP. Level of Evidence 2C Laryngoscope , 130:768–775, 2020