Long-term results of total ossicular chain reconstruction using autografts.

The 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 per cent of the patients benefited significantly.