Tympanoplasty with an Intact Stapes Superstructure in Chronic Otitis Media.

BACKGROUND

The objective of our study was to ascertain the functional results in terms of air bone gap (ABG) closure over 4 frequencies (0.5, 1, 2, 3 kHz) in patients with chronic otitis media (COM) that underwent tympanoplasty in the presence of a mobile stapes superstructure, and in particular excluding those cases in which the malleus was used in the reconstruction.

METHODS

A retrospective review of our database between January 1, 2006 and June 1, 2018 identified all cases that underwent one of 3 reconstructive options: the classic Type III tympanoplasty in an open-cavity setting; the "stapes augmentation" (SA) type reconstruction where the stapes superstructure is augmented to the drum by an interposing partial ossiculoplasty of either autologous bone, cartilage, or prosthetic material; and the use of a total articular replacement prosthesis (TORP) from the stapes footplate to the drum in the presence of an intact superstructure.

RESULTS

A total of 116 procedures in 112 patients were identified with a mean ABG reduction from 27 dB to 21 dB (P < .05). There was no significant difference in the mean post-operative ABG result between Type III (19.21 dB), TORP+ (24.90 dB), or SA (20.94 dB) reconstructions (P = .368). Overall, an ABG ≤ 20 dB or "surgical success" was achieved in 56% (n = 65) of cases. Only 20% (n = 23) of cases had "failure" or a post-operative ABG >30 dB.

CONCLUSION

Tympanoplasty with an intact stapes superstructure in COM is expected to provide acceptable levels of surgical success. We did not identify any particular risk factors associated with improved outcome.