Gluth Michael B, Judd Ryan T, Gurgel Richard K, Dornhoffer John L, Kutz Walter, Carlson Matthew L, Kuthubutheen Jafri, Anderson Ryan D, Killeen Daniel E, Barnes Jason H, Fussell Wanda L, Jeganathan Chaithanya
Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, Illinois, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, U.S.A.
Laryngoscope. 2025 Apr;135 Suppl 2(Suppl 2):S1-S11. doi: 10.1002/lary.31965. Epub 2024 Dec 23.
To determine which ear environment risk factors impact ossiculoplasty hearing outcomes and to generate a statistically-valid grading system for ossiculoplasty outcome reporting.
Retrospective case series.
A multi-institutional database was generated from cases performed between 2011 and 2019. Preoperative and postoperative hearing thresholds were recorded alongside potential ear environment risk factors. Multiple variable linear regression statistical analyses of risk factors were applied to determine independent association with postoperative pure tone average air-bone gap (PTA-ABG). Significant factors were used to generate a statistically-weighted grading scale of Ear Environment Risk (EER).
1679 cases had a mean follow-up time of 33.6 months (SD 36.3) and a mean postoperative PTA-ABG of 21.2 (SD 12.8). Multiple revision status (p < 0.001), presence of canal wall down mastoidectomy cavity (p = 0.020), absent malleus (p < 0.001), absent stapes superstructure (p = 0.016), frequent otorrhea (p = 0.008), pediatric age (p < 0.001), and blunted/lateralized tympanic membrane (p = 0.003) were independently correlated with PTA-ABG. These factors were incorporated into an EER Scoring System with four distinct risk groups wherein each risk group was significantly correlated with PTA-ABG, and this grading system was better correlated with PTA-ABG (Kendall's τ = 0.193) than other existing published grading scales.
Grading environment risk according to a novel EER scoring system generates meaningful risk groupings that correlate with ossiculoplasty postoperative PTA-ABG, and this holds potential to frame reporting of hearing outcomes for future ossiculoplasty research.
3 Laryngoscope, 135:S1-S11, 2025.
确定哪些耳部环境危险因素会影响鼓室成形术的听力结果，并生成一个具有统计学效度的鼓室成形术结果报告分级系统。
回顾性病例系列研究。
从2011年至2019年期间进行的病例中建立了一个多机构数据库。记录术前和术后听力阈值以及潜在的耳部环境危险因素。对危险因素进行多变量线性回归统计分析，以确定与术后纯音平均气骨导间距（PTA-ABG）的独立相关性。使用显著因素生成耳部环境风险（EER）的统计加权分级量表。
1679例患者的平均随访时间为33.6个月（标准差36.3），术后平均PTA-ABG为21.2（标准差12.8）。多次翻修状态（p < 0.001）、开放式乳突切除腔的存在（p = 0.020）、锤骨缺失（p < 0.001）、镫骨上部结构缺失（p = 0.016）、频繁耳漏（p = 0.008）、儿童年龄（p < 0.001）以及鼓膜钝圆/移位（p = 0.003）与PTA-ABG独立相关。这些因素被纳入一个EER评分系统，该系统有四个不同的风险组，其中每个风险组与PTA-ABG显著相关，并且这个分级系统与PTA-ABG的相关性（肯德尔τ系数=0.193）优于其他已发表的分级量表。
根据新的EER评分系统对环境风险进行分级可产生有意义的风险分组，这些分组与鼓室成形术后的PTA-ABG相关，这有可能为未来鼓室成形术研究的听力结果报告提供框架。
3《喉镜》，135:S1 - S11，2025年。
