The Impact of Smoking on Ossiculoplasty Outcomes.
To assess the impact of tobacco smoking on outcomes after ossiculoplasty.



Case series with chart review.



Tertiary care center.



Adult patients (16-88 yr of age) undergoing ossiculoplasty with cartilage tympanoplasty.



Patients were classified as smokers (TOB) or nonsmokers (TOB). Comparisons were then made between these two groups with regard to early and late audiometric outcomes, rate of cure of conductive hearing loss, rate of successful graft healing, and incidence of complications after surgery.



There was no significant difference between the two groups with regard to postoperative ΔPTA-ABG (change in pure-tone average air-bone gap) (-14.4 dB vs. -14.6 dB for TOB vs. TOB, respectively, p = 0.946) or final audiometric outcome (ΔPTA-ABGfinal) (-13.6 dB vs. -11.7 dB for TOB vs. TOB, respectively, p = 0.315), cure of conductive hearing loss, defined as closure of the PTA-ABG to ≤20 dB HL, at postoperative audiometry (75.0% [129/172] for the TOB group vs. 69.3% [52/75] for the TOB group, p = 0.355), late audiometry (71.4% [105/147] for the TOB group vs. 66.7% [44/66] for the TOB group, p = 0.483), or successful graft healing (99.4% in the TOB group vs. 98.7% in the TOB group, p = 0.544). However, complications were observed significantly (p = 0.0003) more often in the TOB group (34.7% [26/75]) than the TOB group (14.5% [25/172]).



Smoking is not a significant risk factor for anatomic failure of cartilage tympanic membrane graft or worsened audiometric outcome after ossiculoplasty. However, complications were significantly more common in smokers, supporting the practice of primary tympanostomy tube placement at the time of ossiculoplasty.
*Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas†Mater Health Services North Queensland, Mater Medical Centre, Pimlico, QLD, Australia.
Matthew D
MD
Cox
Shane R
SR
Anderson
James Shep
JS
Russell
John L
JL
Dornhoffer
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006314:Hearing Loss, Conductive / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019933:Ossicular Replacement; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016896:Treatment Outcome; D014433:Tympanoplasty; D055815:Young Adult