title: Realities in ossiculoplasty.
abstract: The results of ossiculoplasty are frequently reported in terms of closure of the air-bone gap. This parameter is a reliable indicator of the degree of technical success, and is useful in comparing different materials and types of reconstructions. However assessment of the operated ear alone does not evaluate the effect of surgery on binaural hearing ability, leading to the situation where sub-optimal advice may be given to patients pre-operatively. This article advocates a more patient orientated method of assessing the results of ossiculoplasty. Previous studies have indicated that the operated ear must reach an air conduction level of 30dB for the speech frequencies or be within 15dB of the other ear to ensure that the patient will gain significant benefit. A graphical method for the prediction of patient benefit is presented, and compared to the rule of thumb quoted above. The implications for surgeons and patients considering ossiculoplasty are obvious.
authors.forename: J G
authors.initials: JG
authors.lastname: Toner
authors.forename: G D
authors.initials: GD
authors.lastname: Smyth
authors.forename: A G
authors.initials: AG
authors.lastname: Kerr
mesh_terms: D003258:Consumer Behavior; D006309:Hearing; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D013067:Speech Perception; D013201:Stapes Surgery