Otolaryngology Department, University Hospital of Modena, Modena, Italy.
Otol Neurotol. 2022 Oct 1;43(9):1041-1048. doi: 10.1097/MAO.0000000000003666. Epub 2022 Sep 1.
Ossiculoplasty is aimed at improving or maintaining the conductive portion of hearing in patients subjected to otologic surgery. However, satisfying hearing is frequently observed after tympanoplasty even in the absence of ossicular chain reconstruction. Aims of this article would be to evaluate hearing outcomes, in terms of pure tone average air-bone gap (PTA-ABG), in patients subjected to tympanoplasty for middle ear disease whose ossicular chain has not been reconstructed, and then to investigate factors influencing those outcomes.
Retrospective chart review of patients who underwent ear surgery from year 2003 to 2021 at the Otolaryngology-Head and Neck surgery department of the University Hospital of Modena was performed. Audiometric test results from patients who did not receive any ossicular chain reconstruction were collected and analyzed.
Tertiary University referral center.
The mean patients' follow-up was 34.1 months. Overall, mean PTA-ABG in the study population was 23.5 dB. Integrity of stapes superstructure, malleus handle and malleus head, together with the use of tragal cartilage graft over autologous temporalis fascia to reconstruct the tympanic membrane were found to be significantly associated with better hearing outcomes, as demonstrated by lower PTA-ABG values. Stapes superstructure was found to be associated with more favorable outcomes in multivariate analysis, net of confounding factors.
Good hearing performance can be obtained in patients subjected to middle ear surgery, even if the ossicular chain is not reconstructed. Presence of ossicular chain remnants and the use of a rigid material for tympanic membrane reconstruction are the factors that seem to most favorably influence hearing outcomes after surgery for middle ear disease.
耳骨链成形术旨在改善或维持接受耳科手术患者的传音部分听力。然而，即使在没有重建听小骨链的情况下，鼓室成形术后通常也能获得满意的听力。本文旨在评估未重建听小骨链的中耳疾病患者行鼓室成形术后的听力结果（纯音平均气骨导差，PTA-ABG），并探讨影响这些结果的因素。
对 2003 年至 2021 年在摩德纳大学医院耳鼻喉科接受耳部手术的患者进行回顾性图表审查。收集并分析未接受任何听小骨链重建的患者的听力测试结果。
三级大学转诊中心。
患者的平均随访时间为 34.1 个月。总体而言，研究人群的平均 PTA-ABG 为 23.5dB。镫骨上结构、锤骨柄和锤骨头的完整性以及使用自体颞筋膜上的耳屏软骨移植物重建鼓膜与更好的听力结果显著相关，表现为更低的 PTA-ABG 值。在多变量分析中，去除混杂因素后，发现镫骨上结构与更好的结果相关。
即使不重建听小骨链，中耳手术也能获得良好的听力效果。听小骨链残余物的存在和用于鼓膜重建的刚性材料是影响中耳疾病术后听力结果的最有利因素。
