Abstract
Objective
Identify prognostic factors affecting outcome in ossicular chain reconstruction (OCR).
Methods
Retrospective case series of electronic database at an academic institution. We reviewed 209 cases of OCR performed from January 2000 through September 2007, and systematically collected demographic, clinical, audiologic, and outcome information. Univariate analyses of group differences in terms of postoperative air-bone gap (ABG) changes were evaluated by ANOVA. Multiple regression analyses were used to examine the relationship between postoperative air-bone gap (dependent variable) and the independent variables.
Results
There were 107 cases of OCR which met inclusion criteria (45 primary and 62 revision tympanoplasties) with an average follow-up of 19 months. There were 36 cases of chronic suppurative otitis media without cholesteatoma and 71 cases with cholesteatoma. The mean preoperative ABG was 32 ± 15 dB and the mean postoperative ABG was 23 ± 14 dB (P < 0.001). Of the independent variables analyzed, the type of procedure (i.e., tympanoplasty vs. canal-wall up vs. canal-wall down) and status of malleus handle were predictive of the success of OCR.
Conclusions
Favorable prognostic factors in OCR include smaller preoperative ABG and the presence of an intact malleus handle. Our findings support the practice of performing OCR at the time of the second-look procedure.
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