Related Experiment Videos
Hearing results in pediatric patients with chronic otitis media after ossicular reconstruction with partial ossicular
Insights
Pediatric chronic otitis media patients undergoing ossicular reconstruction showed improved hearing with partial ossicular replacement prostheses (PORPs) over total ossicular replacement prostheses (TORPs). Preoperative hearing significantly impacts outcomes in single-stage surgeries.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Surgical Innovation
Background:
- Chronic otitis media (COM) frequently necessitates surgical intervention in pediatric populations.
- Ossicular reconstruction is a key procedure to restore hearing in COM patients.
- Partial ossicular replacement prostheses (PORPs) and total ossicular replacement prostheses (TORPs) are common prosthetic options.
Purpose of the Study:
- To evaluate and compare hearing outcomes in pediatric patients with COM following ossicular reconstruction using PORPs versus TORPs.
- To identify factors influencing postoperative hearing results in children undergoing single-stage ossicular reconstruction.
Main Methods:
- Retrospective chart review of 55 pediatric patients with COM who underwent ossicular reconstruction between 1991 and 1998.
- Analysis of preoperative and postoperative audiograms, including pure-tone average (PTA), air-bone gap (ABG), and speech reception threshold (SRT).
- Comparison of outcomes based on the type of prosthesis used (PORP or TORP) and mastoid management.
Main Results:
- Patients receiving PORPs demonstrated a greater average reduction in air-bone gap (ABG) compared to those receiving TORPs (22.5 dB vs. 31.6 dB).
- Forty-three percent of children with PORPs achieved a postoperative ABG under 20 dB, compared to 19% with TORPs.
- Approximately 55% of patients in both groups experienced minimal change (≤10 dB) in their ABG post-surgery.
Conclusions:
- Partial ossicular replacement prostheses (PORPs) appear to yield slightly superior postoperative hearing results compared to total ossicular replacement prostheses (TORPs) in pediatric COM patients.
- Preoperative hearing status is a critical determinant of postoperative hearing success in non-staged ossicular reconstruction.
- Poorer hearing outcomes in single-stage surgeries, potentially linked to severe mucosal disease and eustachian tube dysfunction, warrant further investigation.
Objective:
To examine hearing results in pediatric patients after ossicular reconstruction with partial ossicular replacement prostheses (PORPs) and total ossicular replacement prostheses (TORPs) in children with chronic otitis media.
Methods:
A retrospective chart review was performed on 55 pediatric patients with chronic otitis media who underwent ossicular reconstruction from 1991 to 1998. Patients' audiograms were evaluated preoperatively and postoperatively for pure-tone average (PTA), air-bone gap (ABG), speech reception threshold (SRT), method of ossicular reconstruction, and management of the mastoid.
Results:
Twenty-seven patients underwent ossicular reconstruction with TORPs. The average preoperative ABG was 40.1 dB, and the average postoperative ABG was 31.6 dB. Forty-one percent of the children improved their PTA greater than 10 dB postoperatively, and 52% of children did not change their ABG by more than 10 dB postoperatively. Nineteen percent of children with TORPs had a postoperative ABG less than 20 dB, and 44% of children with TORPs had a postoperative ABG less than 30 dB. Twenty-eight patients underwent ossicular reconstruction with PORPs. The average preoperative ABG was 29.7 dB, and the average postoperative ABG was 22.5 dB. Thirty-two percent of patients improved their PTA by greater than 10 dB, while 57% of children with PORPs did not change their ABG by more than 10 dB postoperatively. Forty-three percent of children with PORPs had an ABG of less than 20 dB postoperatively, and 71% of children with PORPs had a postoperative ABG less than or equal to 30 dB.
Conclusions:
Children who underwent ossicular reconstruction with PORPs had slightly better postoperative hearing than did children with TORPs. Postoperative hearing was essentially unchanged in approximately 55% of both groups. Preoperative hearing levels may be the most important factor determining postoperative hearing in nonstaged surgery for children with chronic otitis media Long-term hearing results in children with single-stage surgery were not as good as those reported in the literature for staged surgery. Severe mucosal disease and eustachian tube dysfunction may contribute to poorer hearing results in children.