Abstract:
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.
