Analysis of the effect of reconstructing the ossicular chain under otoendoscopy with and without a stapes superstructure

Abstract

Background

Numerous studies have been conducted on the effect of the stapes superstructure after ossicular chain reconstruction, but the findings are not uniform.

Objective

To compare the hearing outcomes of ossicular chain reconstruction with partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP) under otoendoscopy.

Materials and methods

The records of 111 patients diagnosed with chronic suppurative otitis media were retrospectively analyzed. These patients were divided into PORP group (n = 57) and TORP group (n = 54). They were further subdivided into subgroups PORP-a (with a malleus handle) and PORP-b (without a malleus handle), subgroups TORP-a and TORP-b. Pre- and postoperative audiometric results were analyzed.

Results

The mean postoperative air conduction hearing thresholds improvement, mean air–bone gap improvement, and the success rate of reconstruction were significantly higher in the PORP group than in the TORP group (p < .05). The mean postoperative air conduction hearing thresholds improvement and the success rate of reconstruction were significantly higher in the PORP-a group than in the TORP-a group (p < .05); and similar results were concluded in comparison of the PORP-b group and the TORP-b group.

Conclusions and significance

The stapes superstructure has an important positive effect on the postoperative outcome of endoscopic ossicular chain reconstruction.

Chinese Abstract

背景：对于听骨链重建之后镫骨大结构的影响已经进行了大量的研究, 但研究结果并不统一。

目的：比较通过耳内窥镜下置换假体（PORP）或全听小骨置换假体（TORP）的听骨链重建与部分听骨链重建的听力结果。

材料与方法：对111例慢性化脓性中耳炎患者的记录进行了回顾性分析。 这些患者被分为 PORP 组（n=57）和 TORP 组（n=54）。 它们被进一步细分为 PORP-a（具有锤骨柄）和 PORP-b 亚组（无锤柄）, TORP-a 和 TORP-b 亚组。 对术前和术后听力测试结果进行了分析。

结果：PORP组的术后平均气导听阈改善、平均气骨间隙改善、重建成功率均显著高于TORP 组 (p<.05)。 PORP-a组的术后平均气导听阈改善和重建成功率均显著高于TORP-a组（p<.05）； PORP-b组和TORP-b组的比较也得出类似的结果。

结论及意义：镫骨大结构对内镜听骨链重建的术后效果具有重要的积极作用。

Keywords:

• Otoendoscopy
• partial ossicular replacement prosthesis
• total ossicular replacement prosthesis
• ossicular chain reconstruction
• tympanoplasty
• titanium

Ethical approval

The study was approved by the Ethical Committee of the First Affiliated Hospital of Wenzhou Medical University.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the Wenzhou Science and Technology Bureau [Grant Nos. Y2020027 and Y20220169].