In‐office ossicular chain reconstruction using hydroxyapatite cement

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.

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Ossicular Discontinuity and Exostoses in Proteus Syndrome: A Case Report

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940511400314 ◽

2005 ◽

Vol 114 (3) ◽

pp. 242-246

Author(s):

Joni K. Doherty ◽

Dennis R. Maceri

Keyword(s):

Hearing Loss ◽

High Frequency ◽

Conductive Hearing Loss ◽

Ossicular Chain ◽

Typical Feature ◽

Proteus Syndrome ◽

Frequency Range ◽

Pure Tone Average ◽

Ossicular Chain Reconstruction ◽

Conductive Hearing

Proteus syndrome (PS) is a rare hamartomatous disorder characterized by mosaic overgrowth of multiple tissues that manifests early in life and is progressive. The presence of unilateral external auditory canal exostoses in a patient who is not a swimmer or surfer is suggestive of PS. However, hearing loss is not a typical feature. Here, we describe exostoses and ossicular discontinuity with conductive hearing loss in a patient with PS. The treatment consisted of canalplasty and ossicular chain reconstruction. A postoperative reduction was demonstrated in the patient's air-bone gap, from 21 dB to 13 dB for the pure tone average (four frequencies) and from 41 dB to 15 dB in the high-frequency range (6,000 to 8,000 Hz). Causes of ossicular discontinuity are discussed. Routine annual audiometric and otolaryngological evaluation should be considered in all patients with temporal bone inyolvement of PS.

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Ossicular Chain Reconstruction in a Developing Country

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418760054 ◽

2018 ◽

Vol 127 (5) ◽

pp. 306-311 ◽

Cited By ~ 3

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.

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Plastipore™ Prostheses for Ossicular Chain Reconstruction in Tympanoplasty

Biomaterials in Otology ◽

10.1007/978-94-009-6756-4_22 ◽

1984 ◽

pp. 187-198 ◽

Cited By ~ 3

Author(s):

M. Sanna ◽

R. Gamoletti ◽

M. Magnani ◽

C. Zini

Keyword(s):

Ossicular Chain ◽

Ossicular Chain Reconstruction

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Ossicular Chain Reconstruction (OCR)

Encyclopedia of Otolaryngology, Head and Neck Surgery ◽

10.1007/978-3-642-23499-6_100752 ◽

2013 ◽

pp. 1948-1948

Keyword(s):

Ossicular Chain ◽

Ossicular Chain Reconstruction

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OSSICULAR CHAIN RECONSTRUCTION

The Laryngoscope ◽

10.1288/00005537-198308000-00001 ◽

1983 ◽

Vol 93 (8) ◽

pp. 981???988 ◽

Cited By ~ 48

Author(s):

C. GARY JACKSON ◽

MICHAEL E. GLASSOCOCK ◽

ALAN J. NISSEN ◽

MITCHELL K. SCHWABER ◽

SIDNEY G. CHRISTIANSEN ◽

...

Keyword(s):

Ossicular Chain ◽

Ossicular Chain Reconstruction

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

Otolaryngology ◽

10.1177/0194599819831284 ◽

2019 ◽

Vol 161 (1) ◽

pp. 123-129 ◽

Cited By ~ 4

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.

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