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ORIGINAL ARTICLE   

Otorhinolaryngology 2022 March;72(1):1-7

DOI: 10.23736/S2724-6302.21.02389-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Factors influencing hearing outcome of tympanoplasty with ossicular reconstruction: our experience

Silvia SAPINO 1 , Lorena TRUJILLO OCAMPO 2, Rafael MOYA MARTINEZ 2, Marco TAVASSOLI 1, Ivan DOMENECH JUAN 2, 3

1 Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy; 2 Agrupació Mèdica i Quirúrgica (AMiQ), Functional Unit of Otorhinolaryngology and Allergy, Dexeus University Hospital, Barcelona, Spain; 3 Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain



BACKGROUND: The aim of this retrospective study was to evaluate the role of prognostic factors in determining surgical success of tympanoplasty with ossicular reconstruction.
METHODS: A total of 60 patients who underwent tympanoplasty with ossicular reconstruction operations between 2012 and 2018 were reviewed. Factors such as age, location of the tympanic perforation, duration of the dry period, history of previous surgery, operation type, status of middle ear, status of ossicular chain and type of reconstruction were registered. Each patient underwent audiologic evaluation pre- and postoperatively.
RESULTS: A postoperative air-bone gap ≤20 dB was considered a surgical success. The success rate was 72.9%. The presence of cholesteatoma was found to be a statistically significant prognostic factor (P=0.0131) influencing hearing outcome. No significant difference on surgical success was observed regarding presence of otorrhea (P=0.4820), tympanic membrane status (P=0.4702), type of surgical access (P=0.1590), ossicular chain status (P=0.1336), type of tympanic reconstruction (P=0.3710), type of ossicular chain reconstruction (p>0.05) and history of previous surgery (P>0.05). A higher percentage of surgical success was found when reconstruction was made with autologous material (75.0%) than with titanium prostheses (71.1%), with TORP (76.2%) when compared to use of PORP (64.7%) and with total ossicular reconstruction (76.2%) versus partial ossicular reconstruction (70.3%), even if in none of the cases the difference reaches statistical significance (P>0.05).
CONCLUSIONS: The presence of cholesteatomatous otitis media was the only prognostic factor influencing surgical success. In terms of hearing results, we found that is better to perform an ossiculoplasty than not performing it, regardless of the technique used. In any case we observed a trend in favor of ossicular reconstruction with autologous material when compared to titanium prosthesis and in favor of TORP when compared to PORP.


KEY WORDS: Hearing; Tympanoplasty; Ossicular prosthesis

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