Hearing Outcomes after Revision Stapedectomy Managed with Total Ossicular Reconstruction Prostheses. (2nd September 2014)

• Record Type: Journal Article
• Authors: Lupo, J. Eric; Strickland, Brian M.; House, John W.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 151(2014)Supplement 1
• Page Start: P87
• Page End: P87
• Publication Date: 2014-09-02
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814541627a182
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: (1) Describe the use of total ossicular reconstruction prostheses (TORP) during revision stapedectomy in the setting of advanced incus erosion. (2) Analyze the short‐ and medium‐term audiometric results of TORP for revision stapedectomy. Methods: A retrospective case review at a tertiary neurotological referral center was conducted of nineteen cases of revision stapedectomy where TORP reconstruction was performed due to advanced incus erosion. Pre‐ and postoperative bone conduction (BC‐PTA) and air conduction (AC‐PTA) pure tone averages (0.5, 1, 2, 3 kHz) including high tone bone conduction (1, 2, 3 kHz), air‐bone gap (ABG), and speech discrimination scores (SDS) were measured. Short‐term (3 weeks) and medium‐term (median, 12 months) hearing outcomes were measured. Results: Among 19 ears undergoing revision stapedectomy managed with TORP reconstruction, the average number of previous revision attempts was 1.2 (SD, 2; range, 1‐6). The preoperative BC‐PTA was 32.1 dB preoperatively while the preoperative AC‐PTA was 65.3 dB. The mean postoperative ABG significantly decreased to 16.6 dB (SD, 13.68; range, −2.5 to 46.3 dB, P <. 003) with mean follow‐up of 15 months (SD, 18.8; range, 0.75‐54 months). A nonsignificant mean high tone BC‐PTA decrement of 3.8 dB (SD = 5.9, range −8.33 to 18.33 dB, P =. 427) was observed including one ear with no responses postoperatively. No further revisions were noted in follow‐up. Conclusions: Total ossicular reconstruction in the setting of previous revision stapedectomy with limited incudovestibular reconstructive options may lead to favorable hearing outcomes but carries an increased risk of sensorineural hearing loss.