Marc D Polanik1,2,3, Danielle R Trakimas4, Nicole L Black1, Jeffrey T Cheng1,5, Elliott D Kozin1,5, Aaron K Remenschneider1,2,3,5. 1. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA. 2. Department of Otolaryngology, UMass Memorial Medical Center, Worcester, Massachusetts, USA. 3. University of Massachusetts Medical School, Worcester, Massachusetts, USA. 4. Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. 5. Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
OBJECTIVES: Conventional reporting of posttympanoplasty hearing outcomes use a pure-tone averaged air-bone gap (ABG) largely representing a low-frequency sound conduction. Few studies report high-frequency conductive hearing outcomes. Herein, we evaluate high-frequency ABG in patients following temporalis fascia total drum replacement. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care center. SUBJECTS AND METHODS: All patients who underwent type 1 tympanoplasty using a lateral graft total drum replacement technique between August 2016 and February 2019 were identified. Patients with pre- and postoperative audiograms were included. Low-frequency ABG was calculated as the mean ABG at 250, 500, and 1000 Hz. High-frequency ABG was calculated at 4 KHz. Pre- and postoperative ABGs were compared. RESULTS: Twenty-three patients were included, and the mean age at surgery was 44 years (range, 9-68 years). Perforation etiology was from trauma (n = 14) or chronic otitis media (n = 9). Preoperative mean low-frequency ABG was 27.8 ± 12.6 dB and mean high-frequency ABG was 21.5 ± 15.1 dB (P = .044). Postoperatively, the mean low-frequency ABG was significantly reduced by 15.5 ± 13.3 dB (P < .001) while the mean high-frequency ABG insignificantly changed (reduced by 2.6 ± 16.2 dB, P = .450). CONCLUSION: In a series of patients undergoing temporalis fascia total drum replacement, low-frequency ABG improved; however, high-frequency conductive hearing loss persists. Conventional methods of reporting ABG may not identify persistent high-frequency ABG. These results merit further study across a range of tympanoplasty graft materials and surgical techniques.
OBJECTIVES: Conventional reporting of posttympanoplasty hearing outcomes use a pure-tone averaged air-bone gap (ABG) largely representing a low-frequency sound conduction. Few studies report high-frequency conductive hearing outcomes. Herein, we evaluate high-frequency ABG in patients following temporalis fascia total drum replacement. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care center. SUBJECTS AND METHODS: All patients who underwent type 1 tympanoplasty using a lateral graft total drum replacement technique between August 2016 and February 2019 were identified. Patients with pre- and postoperative audiograms were included. Low-frequency ABG was calculated as the mean ABG at 250, 500, and 1000 Hz. High-frequency ABG was calculated at 4 KHz. Pre- and postoperative ABGs were compared. RESULTS: Twenty-three patients were included, and the mean age at surgery was 44 years (range, 9-68 years). Perforation etiology was from trauma (n = 14) or chronic otitis media (n = 9). Preoperative mean low-frequency ABG was 27.8 ± 12.6 dB and mean high-frequency ABG was 21.5 ± 15.1 dB (P = .044). Postoperatively, the mean low-frequency ABG was significantly reduced by 15.5 ± 13.3 dB (P < .001) while the mean high-frequency ABG insignificantly changed (reduced by 2.6 ± 16.2 dB, P = .450). CONCLUSION: In a series of patients undergoing temporalis fascia total drum replacement, low-frequency ABG improved; however, high-frequency conductive hearing loss persists. Conventional methods of reporting ABG may not identify persistent high-frequency ABG. These results merit further study across a range of tympanoplasty graft materials and surgical techniques.
Authors: J Claes; P H Van de Heyning; W Creten; E Koekelkoren; C Van Laer; D De Saegher; A Graff Journal: Laryngoscope Date: 1990-12 Impact factor: 3.325
Authors: Danielle R Trakimas; Reuven Ishai; Iman Ghanad; Nicole L Black; Elliott D Kozin; Jeffrey Tao Cheng; Aaron K Remenschneider Journal: Laryngoscope Date: 2018-05-14 Impact factor: 3.325
Authors: Marc D Polanik; Danielle R Trakimas; Melissa Castillo-Bustamante; Jeffrey T Cheng; Elliott D Kozin; Aaron K Remenschneider Journal: Laryngoscope Investig Otolaryngol Date: 2020-06-26
Authors: Prithwijit Roychowdhury; Marc D Polanik; Judith S Kempfle; Melissa Castillo-Bustamante; Cheryl Fikucki; Michael J Wang; Elliott D Kozin; Aaron K Remenschneider Journal: Laryngoscope Investig Otolaryngol Date: 2021-06-11
Authors: Xiaohui Lin; Sebastiaan W F Meenderink; Glenna Stomackin; Timothy T Jung; Glen K Martin; Wei Dong Journal: J Assoc Res Otolaryngol Date: 2021-02-16