Long-term Follow-up Study of the Sandwich Cartilage Shoe Technique in Cases of Insecure Stapes Footplate

Abstract

Objective: 

Analysis of the audiometric results after repair of a defective footplate with the sandwich cartilage shoe technique in a follow-up study.

Study Design: 

Retrospective analysis of audiometric data.

Setting: 

Hospital.

Patients: 

The cohort consisted of 12 patients, who underwent ossicular reconstruction after sandwich cartilage shoe technique in a case of insecure stapes footplate. The mean age was 42.7 years with an equal sex distribution. In every patient, cholesteatoma was the reason for surgery with 75% being revision cases.

Intervention: 

Sandwich cartilage shoe technique in case of insecure stapes footplate at the department of otorhinolaryngology, head and neck surgery at the University of Cologne over an 8-year period (2007–2015).

Main Outcome Measure: 

The use of the “sandwich cartilage shoe technique” in case of a broken or unstable footplate allows a safe occlusion of the open vestibule.

Results: 

The statistical analysis revealed a significant improvement of the pure-tone average (p = 0.011) and air-bone gap (ABG) (p = 0.016) after total ossicular replacement prosthesis (TORP) implantation. The hearing was stable at 9 months of follow up.

Conclusion: 

The sandwich cartilage shoe technique offers a safe and effective option as a two-stage procedure in treating patients with fractures of the stapes footplate in case of chronic otitis media. In view of the possible risk of deafness going along with a destruction of an inner ear window, our results can be considered substantial as all our patients will at least be able to regain “social hearing” as they all either achieved a hearing threshold is less than 30 dB or can be sufficiently supplied with a conventional hearing aid.