Piyush Kant Singh1, Samneet Saggu2, Preeti Singh3
BACKGROUND
Otologists always yearn to improve the hearing outcome of their patients with
chronic suppurative otitis media. There are different options for ossiculoplasty to
choose from, depending on the extent of disease, condition of ossicular chain and
availability of implant material and there has always been a quest to make
appropriate decision with a predictable outcome. In this study, we have tried to
analyse various factors which can affect hearing outcome after Ossiculoplasty.
METHODS
A retrospective study was done to study the effect of implant material, condition
of ossicular chain and disease in the mastoid on post-operative hearing
improvement on 200 patients, who underwent tympanoplasty or tympanomastoidectomy
from January 2018 to January 2020, in Department of
Otorhinolaryngology and Head and Neck Surgery, K.D. Medical College, Mathura.
Decision of ossiculoplasty was made based on intra-operative findings. Autograft
incus, Teflon TORP (total ossicular replacement prosthesis) and cartilage columella
were used based on availability and feasibility.
RESULTS
Mean improvement in average air-bone gap of 200 patients was found to be 18.57
dB, with autograft incus, it was 19.99 dB, with Teflon TORP (total ossicular
replacement prosthesis), 19.53 dB and with cartilage columella 16.73 dB (P =
0.023). Mean hearing improvement was 18.98 dB when handle of malleus was
present and 15.59 dB when it was absent (P = 0.023). Mean hearing improvement
was 19.42 dB when stapes superstructure was present and 16.92 dB when it was
absent (P = 0.016). Even though the hearing outcome was better when mastoid
was disease free (19.57 dB) compared to when it was diseased (18.30 dB), the
difference was not statistically significant. (P = 0.177)
CONCLUSIONS
In our study, we found autograft incus to be the best material for ossiculoplasty
and presence of handle of malleus and stapes superstructure improved postoperative
hearing outcome significantly but involvement of mastoid by disease did
not significantly affect the hearing outcome post-operatively.
