title: Long-term Outcomes of Titanium Ossiculoplasty in Chronic Otitis Media.
abstract: The primary objective is to report long-term hearing outcomes (>2 years) after titanium ossiculoplasty in patients with chronic otitis media.
  
  
  
  Case series with chart review.
  
  
  
  Tertiary care hospital.
  
  
  
  In total, 156 patients with chronic otitis media undergoing titanium ossiculoplasty were included. The primary outcome measure was the long-term postoperative ABG. The stability of hearing over time was determined by comparing short-term and long-term postoperative air-bone gap (ABG). Secondary outcome measures included ΔABG, postoperative speech reception thresholds, air-conduction pure-tone average (AC PTA), word recognition scores, and percentage of patients achieving ABG ≤20 dB. Revision and extrusion rates were examined.
  
  
  
  At short-term follow-up (<6 months), mean postoperative ABG was 18.4 ± 10.6 dB and AC PTA was 31.7 ± 15.2 dB; 67% of patients achieved ABG ≤20 dB. At long-term follow-up (>2 years), mean ABG was 20.0 dB ± 15.4 and AC PTA was 35.3 ± 16.1 dB; 60% of patients achieved ABG ≤20. At both short- and long-term follow-up, ABG and AC PTA were significantly improved compared with preoperative values. No difference in hearing outcomes was observed when comparing partial titanium ossicular prostheses (PORPs) to total titanium ossicular prostheses (TORPs) at either short- or long-term follow-ups. In patients with both short- and long-term follow-up (n = 50), deterioration in hearing was noted (3.4 dB, P = .04). When analyzed by type of prosthesis, PORPs demonstrated statistically significant deterioration in ABG over time (4.9 dB, P = .02), while TORPs did not (2.5 dB, P = .50). The long-term extrusion rate was 3.2%.
  
  
  
  With a minimum follow-up of 2 years, titanium ossiculoplasty provides good long-term hearing results. Modest deterioration in hearing is noted over time.
authors.affiliation: Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee, USA brendanoconnel@gmail.com.
authors.forename: Brendan P
authors.initials: BP
authors.lastname: O'Connell
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Habib G
authors.initials: HG
authors.lastname: Rizk
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Tanisha
authors.initials: T
authors.lastname: Hutchinson
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Nguyen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Lambert
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone; D001844:Bone Conduction; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D019933:Ossicular Replacement / Q000379:methods*; D010033:Otitis Media / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium
keywords: chronic ear disease; chronic otitis media; ossicular chain reconstruction; ossiculoplasty; titanium