Ossicular chain reconstruction: endoscopic or microscopic?

2021 ◽  
pp. 1-7
Author(s):  
E A Guneri ◽  
A Cakir Cetin
Keyword(s):  
Word Recognition ◽  
Middle Ear ◽  
Risk Index ◽  
Ossicular Chain ◽  
Recognition Score ◽  
Reconstruction Surgery ◽  
Ossicular Chain Reconstruction ◽  
Operation Duration ◽  
Air Conduction

Abstract Objective To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery. Methods Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air–bone gap, air–bone gap gain, word recognition score, mean operation duration and mean post-operative follow up. Results Post-operative air conduction, air–bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air–bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air–bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001). Conclusion Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

Long-term results of total ossicular chain reconstruction using autografts

1992 ◽  
Vol 106 (8) ◽  
pp. 688-691 ◽  
Author(s):  
T. R. Kapur ◽  
S. Jayaramchandran
Keyword(s):  
Success Rate ◽  
Anatomical Variation ◽  
Ossicular Chain ◽  
Oval Window ◽  
Long Term Results ◽  
Ossicular Chain Reconstruction ◽  
Cause Of Failure ◽  
Air Conduction

AbstractThe long-term results of 63 total ossicular chain reconstructions using autografts is presented. The follow-up period ranged from 18 months to 18 years with an average of 8.5 years. The primary aims of the study were firstly to assess the long-term success rate and to find out if there were any hitherto unknown causes of bone graft failure. In the event, it was found that the recently described anatomical variation of the oval window viz., the deep oval window, was the prime cause of failure in 32 per cent of unsuccessful cases. Some measures to help to mitigate this problem, are suggested. The result were assessed on the basis of:1. A minimum gain of 20 dB HL in air conduction (Technical success). The success rate was 55.5 per cent.2. Patients benefited using Smyth and Patterson's criteria in conjunction with the Glasgow Benefit Plot; 54 percent of the patients benefited significantly.

Ossicular Chain Reconstruction in a Developing Country

2018 ◽  
Vol 127 (5) ◽  
pp. 306-311 ◽  
Author(s):  
Es-Hak Bedri ◽  
Miriam Redleaf
Keyword(s):  
Tympanic Membrane ◽  
Developing Country ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Ossicular Chain ◽  
Single Stage ◽  
Limited Resources ◽  
Closure Rate ◽  
Average Improvement ◽  
Ossicular Chain Reconstruction

Objectives: In Ethiopia, 2-stage operations with middle ear prostheses are economically unfavorable. We hypothesized that single-stage autologous ossiculoplasty results in acceptable tympanic membrane (TM) and hearing improvements in a setting of limited resources. Methods: One hundred eighty-eight patients (197 ears) who underwent 1-stage autologous ossiculoplasty for ossicular dysfunction are presented. All but 14 of these ears also had perforations of the TM. Conditions of the middle ear were granulation tissue, ossicular disruption only, tympanosclerosis, and cholesteatoma. Reconstructions of the ossicular chain were performed with autologous ossicles only. Results: The closure rate of TM perforations was 95%. Preoperative air bone gaps were 27 to 60 dB (mean [SD] = 44 [7] dB); postoperative air bone gaps were 0 to 50 dB (average [SD] = 23 [10] dB), for an average improvement of 21 dB across all reconstruction types ( P < .001). The largest favorable changes in air bone gaps were with incus and malleus columellas from the footplate to the TM (33 and 23 dB, respectively) ( P < .001). No patient had worsening of sensorineural hearing levels or extrusion of the reconstructed ossicles. Conclusion: Autologous ossiculoplasty performed well in this setting. Acceptable TM closure rates and improvement of air bone gaps were seen in 1-stage operations without the use of prostheses.

Long-Term Hearing Outcomes following Total Ossicular Reconstruction with Titanium Prostheses

2019 ◽  
Vol 161 (1) ◽  
pp. 123-129 ◽  
Author(s):  
C. Burton Wood ◽  
Robert Yawn ◽  
Anne Sun Lowery ◽  
Brendan P. O’Connell ◽  
David Haynes ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Ossicular Chain ◽  
Tertiary Care Center ◽  
Ossicular Chain Reconstruction ◽  
The Mean ◽  
Hearing Outcomes

Objective(1) Characterize a large cohort of patients undergoing total ossicular chain reconstruction with titanium prosthesis. (2) Analyze long-term hearing outcomes of the same cohort.Study DesignCase series with chart review.SettingTertiary care center.Subject and MethodsThis study reviews patients who underwent total ossicular chain reconstruction (OCR) with titanium prostheses (TORPs) at a single tertiary care center from 2005 to 2015. Patient charts were reviewed for demographic data, diagnosis, and operative details. Patients were included in statistical analysis if length of follow-up was 2 years or more. Evaluation of hearing improvement was made by comparing preoperative air-bone gap (ABG) and ABG at follow-up at 2 years.ResultsIn total, 153 patients were identified who met inclusion criteria. The mean age of included patients was 40 years (range, 6-89 years). Sixty patients (39%) had a history of OCR, and 120 patients (78%) had a diagnosis of cholesteatoma at the time of OCR. Preoperatively, the mean ABG was 36 ± 12, whereas the mean ABG at 2-year follow-up improved to 26 ± 13. This was statistically significant ( P < .0001) using a Wilcoxon matched-pairs signed rank test. Twelve patients (8%) required revision OCR. Two revisions were performed due to prosthesis extrusion (<1%).ConclusionTitanium prostheses lead to significant improvement in hearing over long periods. The results are sustained as far out as 5 years following surgery. In addition, rates of revision surgery with titanium TORPs are low. Based on this series, there are no readily identifiable predictors for outcomes following total OCR.

A new device for real-time peroperative monitoring of ossicular chain reconstruction during middle ear surgery

2019 ◽  
Vol 34 (4) ◽  
pp. 827-832
Author(s):  
Van Son Nguyen ◽  
Didier Rouxel ◽  
Brice Vincent ◽  
Joël Ducourneau ◽  
Cécile Parietti-Winkler
Keyword(s):  
Real Time ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
New Device ◽  
Ossicular Chain Reconstruction

Interposed Cartilage as a Precaution against Extrusions of Ceramic Ossicular Replacement Implants

1987 ◽  
Vol 96 (2) ◽  
pp. 207-209 ◽  
Author(s):  
Christoph Zöllner
Keyword(s):  
Middle Ear ◽  
Ossicular Chain ◽  
Oxide Ceramic ◽  
Small Disk ◽  
Middle Ear Implant ◽  
Ossicular Replacement ◽  
Middle Ear Implants ◽  
Aluminum Oxide Ceramic ◽  
Postoperative Observation

Since 1980 we have used middle ear implants of aluminum oxide ceramic in some reconstructions of the ossicular chain. We had opportunities to examine 108 ears (91 patients); the longest period of postoperative observation was 4 years. Follow-up examinations showed that the rates of extrusion and liability to extrusion can be reduced by interposing a small disk of autologous cartilage and perichondrium. Moreover, interposing cartilage tends to improve audiometric results. On the basis of our study, we strongly recommend the interposition of a disk of autologous cartilage and perichondrium between the middle ear implant and eardrum when an Al2O3 implant is used.

The styloid process in ossicular chain reconstruction

1988 ◽  
Vol 102 (2) ◽  
pp. 136-137 ◽  
Author(s):  
S. B. Ogale ◽  
C. Desouza ◽  
J. Sheode ◽  
K. L. Shah
Keyword(s):  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Styloid Process ◽  
Long Term Results ◽  
Graft Material ◽  
Ossicular Chain Reconstruction ◽  
One Year

AbstractOur pilot study reports twenty-six cases of resolved chronic otitis media in which the human, cadaveric styloid process was used as an ossicular graft material. A maximum follow-up of one year is presented in this paper. There was no extrusion or rejection of the styloid processes. Hearing improvement with a closure of the air-bone gap to within 10–15 dB. of the pre-operative bone conduction was found in most cases. So far the styloid process has proved to be an ideal ossicular graft though the long-term results are yet to be seen.

Is it the Middle Ear Disease or the Reconstruction Material That Determines the Functional Outcome in Ossicular Chain Reconstruction?

2012 ◽  
Vol 33 (4) ◽  
pp. 580-585 ◽  
Author(s):  
Uygar Levent Demir ◽  
Sait Karaca ◽  
Omer Afsn Ozmen ◽  
Fikret Kasapoglu ◽  
Hamdi Hakan Coskun ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Ossicular Chain Reconstruction ◽  
Middle Ear Disease
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