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Audiometric Outcomes Following Endoscopic Ossicular Chain Reconstruction

Yawn, Robert J.*; Hunter, Jacob B.*; O’Connell, Brendan P.*; Wanna, George B.*; Killeen, Daniel E.; Wick, Cameron C.; Isaacson, Brandon; Rivas, Alejandro*

doi: 10.1097/MAO.0000000000001527

Objective: To evaluate the audiometric outcomes following endoscopic ossicular chain reconstruction (OCR).

Study Design: Retrospective case series.

Setting: Two tertiary referral centers.

Patients: Sixty two ears with ossicular discontinuity.

Intervention(s): Endoscopic and microscopic OCR in patients with ossicular discontinuity.

Main Outcome Measures: Bone and air pure-tone averages (PTA), air-bone gap (ABG), and word recognition scores (WRS).

Results: Sixty two ears were included for analysis. Patients that underwent ossiculoplasty were subdivided based on prosthesis type (total ossicular replacement prosthesis [TORP] and partial ossicular replacement prosthesis [PORP], primary and staged ossiculoplasties, and surgical approach [microscopic and total endoscopic]). Forty two ears required PORP reconstructions, while 20 ears required TORP reconstructions. The microscope was used to reconstruct the ossicular chain in 31 cases, while an exclusive endoscopic approach was used in the remaining 31 patients. Controlling for the prosthesis, there were no significant postoperative differences in bone PTA, air PTA, and ABG between primary and staged ossiculoplasties, or surgical approach.

Conclusions: Controlling for the type of prosthesis, there were no significant differences in hearing outcomes with respect to staged ossicular chain reconstruction or whether the endoscope or microscope was used for visualization. Thus, in this series, endoscopic OCR yields similar audiometric outcomes when compared with microscopic OCR.

*Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee

Department of Otolaryngology–Head and Neck Surgery, UT Southwestern, Dallas, Texas

Address correspondence and reprint requests to Alejandro Rivas, M.D., Department of Otolaryngology–Head and Neck Surgery, The Bill Wilkerson Center for Otolaryngology & Communication Sciences, 7209 Medical Center East, South Tower 1215 21st Avenue South, Nashville, TN 37232-8605; E-mail:

Financial Material & Support: no funding or other support was required for this study.

Institutional review board approval: Vanderbilt University IRB Approval: 141631, UTSW IRB Approval: STU 022012-060.

A.R.: Consultant for Med-El, Advanced Bionics, Cochlear, Grace Medical, Stryker, and Olympus. B.I.: Consultant for Advanced Bionics, Stryker, Storz, Olympus, and Medtronic.

The authors disclose no conflicts of interest.

Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company