Malleus handle: determinant of success in ossiculoplasty.
OBJECTIVE
The purpose of this study is to identify prognostic factors affecting outcome in ossicular chain reconstruction (OCR).


METHODS
This study is a retrospective case series of electronic database at an academic institution.


METHODS
We reviewed 209 cases of chronic supportive otitis media performed from January 2000 through December 2007 and collected demographic, clinical, audiologic, and outcome information. Univariate analyses of group differences in terms of postoperative air-bone gap (ABG) changes were evaluated by analysis of variance. Multiple regression analyses were used to examine the relationship between postoperative ABG and the independent variables.


RESULTS
There were 105 cases of OCR the met the inclusion criteria (44 primary and 61 revision tympanoplasties), with an average follow-up of 19 months. The diagnoses were chronic suppurative otitis media without cholesteatoma in 36 cases and cholesteatoma in 69 cases. The mean preoperative ABG was 34 +/- 15 dB, and the mean postoperative ABG was 20 +/- 14 dB (P < 0.001). Of the independent variables analyzed, the type of procedure (ie, OCR performed during second-look tympanoplasty vs canal wall up vs canal wall down), preoperative ABG, and status of malleus handle were predictive of the success of OCR.


CONCLUSIONS
Favorable prognostic factors in OCR include smaller preoperative ABG and the presence of an intact malleus handle.
Bared
Anthony
A
University of Miami Miller School of Medicine, Miami, FL, USA.
Angeli
Simon I
SI
D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry / Q000379:methods; D002648:Child; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology; D006801:Humans; D008297:Male; D008307:Malleus / Q000637:transplantation*; D008875:Middle Aged; D019933:Ossicular Replacement / Q000379:methods*; D010035:Otitis Media, Suppurative / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult