Prognostic factors in ossiculoplasty.
OBJECTIVE
To analyze predictive factors of outcome after ossiculoplasty using a standard ossicular prosthesis system.


METHODS
Retrospective review of 140 ossiculoplasties, performed by the same senior surgeon, with titanium prostheses.


METHODS
Academic hospital and tertiary referral center.


METHODS
All patients undergoing ossiculoplasty with Spiggle and Theis or Kurz titanium total and partial prostheses. Documented, postoperative follow-up had to be provided. A total of 129 patients (140 ears; 53 men and 76 women) were evaluated.


METHODS
These included ossiculoplasties using 75 Spiggle and Theis prostheses (30 partial and 45 total) and 65 Kurz prostheses (35 partial and 30 total).


METHODS
Mean preoperative and postoperative air-bone gaps and the changes in mean hearing loss were analyzed using a four-frequency (500, 1,000, 2,000, and 3,000 Hz) pure tone average. Success rate was defined as postoperative air-bone gap within 20 dB. A one-way analysis of variance was used to analyze group differences. A multivariate statistical analysis was then undertaken to define the significant factors.


RESULTS
There were no statistical difference between the Spiggle and Theis and the Kurz prostheses. Multivariate statistical analysis has identified the predictive value of the presence or absence of the malleus handle and the mucosal status of the middle ear in the prognosis of ossiculoplasties.


CONCLUSIONS
Anatomical and technical factors diversely affect the functional outcome of tympano-ossiculoplasties. A better knowledge of their predictive value will enable accurate, preoperative, individual assessment when counseling patients with regard to the success of any proposed intervention. The use of these factors will also permit precise matching of future series to allow accurate comparisons.
De Vos
Caroline
C
ENT Department, University Hospital Saint-Luc, Brussels, Belgium.
Gersdorff
Michel
M
Gérard
Jean-Marc
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000473:pathology / Q000601:surgery*; D004429:Ear Ossicles / Q000503:physiopathology / Q000601:surgery*; D004432:Ear, Middle / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008307:Malleus / Q000601:surgery; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013067:Speech Perception / Q000502:physiology; D013201:Stapes Surgery; D014025:Titanium / Q000627:therapeutic use; D014433:Tympanoplasty
D014025:Titanium