J L Dornhoffer1, E Gardner. 1. Department of Otolaryngology/Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Abstract
OBJECTIVE: To determine factors that predict hearing results using a standard prosthesis system. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: All patients undergoing ossiculoplasty with the Dornhoffer HAPEX partial and total ossicular replacement prostheses (PORP and TORP) from February 1995 to May 1999 who had documented postoperative follow-up and no congenital atresia or stapes fixation. A total of 185 patients (200 ears), 105 men and 80 women, were evaluated. INTERVENTIONS: Ossiculoplasty with the Dornhoffer prostheses. MAIN OUTCOME MEASURES: Hearing results using a four-frequency pure-tone average air-bone gap (PTA-ABG). Multivariate statistical analysis determined the effect of mucosal status, ossicular chain status, and type of reconstruction techniques on hearing. RESULTS: The PTA-ABGs were 13.4+/-8.1 dB and 14.0+/-8.4 dB for the PORPs (n = 114) and TORPs (n = 86), respectively, which was not statistically different. When the malleus handle was present (n = 126), the PTA-ABG was 11.6+/-6.2 dB, compared with 16.9+/-10.1 dB when it was absent (n = 74), which was statistically significant (p < 0.05). Mucosal fibrosis, drainage, revision ear surgery, and type of surgical procedure had a significant detrimental impact on hearing. The type of pathologic process (perforation vs. cholesteatoma) had no significant impact on hearing results. CONCLUSIONS: The revised staging system, the Ossiculoplasty Outcome Parameter Staging Index, more adequately predicts hearing outcome in this series of 200 cases.
OBJECTIVE: To determine factors that predict hearing results using a standard prosthesis system. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: All patients undergoing ossiculoplasty with the Dornhoffer HAPEX partial and total ossicular replacement prostheses (PORP and TORP) from February 1995 to May 1999 who had documented postoperative follow-up and no congenital atresia or stapes fixation. A total of 185 patients (200 ears), 105 men and 80 women, were evaluated. INTERVENTIONS: Ossiculoplasty with the Dornhoffer prostheses. MAIN OUTCOME MEASURES: Hearing results using a four-frequency pure-tone average air-bone gap (PTA-ABG). Multivariate statistical analysis determined the effect of mucosal status, ossicular chain status, and type of reconstruction techniques on hearing. RESULTS: The PTA-ABGs were 13.4+/-8.1 dB and 14.0+/-8.4 dB for the PORPs (n = 114) and TORPs (n = 86), respectively, which was not statistically different. When the malleus handle was present (n = 126), the PTA-ABG was 11.6+/-6.2 dB, compared with 16.9+/-10.1 dB when it was absent (n = 74), which was statistically significant (p < 0.05). Mucosal fibrosis, drainage, revision ear surgery, and type of surgical procedure had a significant detrimental impact on hearing. The type of pathologic process (perforation vs. cholesteatoma) had no significant impact on hearing results. CONCLUSIONS: The revised staging system, the Ossiculoplasty Outcome Parameter Staging Index, more adequately predicts hearing outcome in this series of 200 cases.
Authors: Hannes Maier; Uwe Baumann; Wolf-Dieter Baumgartner; Dirk Beutner; Marco D Caversaccio; Thomas Keintzel; Martin Kompis; Thomas Lenarz; Astrid Magele; Torsten Mewes; Alexander Müller; Tobias Rader; Torsten Rahne; Sebastian P Schraven; Burkard Schwab; Georg Mathias Sprinzl; Bernd Strauchmann; Ingo Todt; Thomas Wesarg; Barbara Wollenberg; Stefan K Plontke Journal: Audiol Neurootol Date: 2018-09-07 Impact factor: 1.854