Myringostapediopexy: is it a natural type III tympanoplasty?
BACKGROUND
Natural myringostapediopexy is an infrequent abnormality, and studies about resulting hearing loss are scarce. In several cases, natural myringostapediopexy may function as a Type III tympanoplasty.


OBJECTIVE
This study evaluated conductive hearing loss in myringostapediopexy.


METHODS
This cross-sectional comparative study included a historical and current sample of 46 patients, one with bilateral myringostapediopexy, at a total of 47 ears. All underwent pure tone and speech audiometry and were divided according to age into a pediatric (younger than 18 yr) and an adult group. The Statistical Package for Social Science (SPSS) 10.0 was used for statistical analysis, and the level of significance was set at p lower than 0.05.


RESULTS
Patient distribution according to sex was similar (53.2% male), and 57.4% were adults. Mean conductive hearing loss in ears with myringostapediopexy ranged from 14.13 to 21.28 dB according to the frequency assessed. Pure tone average was 18.46 dB. A conductive hearing loss equal to or lower than 25 dB at all frequencies was found in 53% of the patients. The 2,000 and 3,000 Hz frequencies had the greatest prevalence of clinically nonsignificant conductive hearing loss (87% and 91%). Sensorineural hearing loss was found in 14 patients (30%), all adults, and 43% of the cases were mild. The comparison according to age did not reveal any significant differences in conductive hearing loss at any of the frequencies.


CONCLUSIONS
Most patients with natural myringostapediopexy included in the study had clinically irrelevant conductive hearing loss. There were no differences in conduction loss between children and adults. The reconstruction of the ossicular chain and tympanoplasty, for purely functional reasons, are not justified in these cases, particularly not for patients with mixed hearing loss.
Department of Otolaryngology-Head and Neck Surgery, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. viviboms@gmail.com
Viviane Bom
VB
Schmidt
Sady Selaimen
SS
da Costa
Letícia Petersen Schmidt
LP
Rosito
Inesângela
I
Canali
Fábio André
FA
Selaimen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry; D001844:Bone Conduction; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006314:Hearing Loss, Conductive / Q000503:physiopathology* / Q000601:surgery; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D014432:Tympanic Membrane / Q000002:abnormalities* / Q000601:surgery; D014433:Tympanoplasty