Long-term results in ossiculoplasty: an analysis of prognostic factors

The aim of the present study is to examine the prognostic factors based on 6-month and 5-year results of ossiculoplasty.

Retrospective analysis was made on the ossiculoplasty cases in a county hospital. The information was extracted from a computer database.

All patients who had ossiculoplasty were routinely followed up in a dedicated ear audit clinic on a yearly basis. Between 1988 and 1999, 242 ossiculoplasties for chronic otitis media were performed on 197 patients. Only the first ossiculoplasty operation performed on each patient during the study period was included in the analysis. The 6-month and 5-year results were analyzed. Two different statistical methods were used--logistic regression analysis and the analysis of variance (ANOVA). A successful ossiculoplasty is defined as a postoperative air-bone gap (ABG) of 20 dB or better.

The overall success rate of ossiculoplasty was 66.5% at 6 months and 50.3% at 5 years. In a multivariate analysis using logistic regression, those with present malleus were 6.36 times more likely to be successful. Using ANOVA, absent malleus and otorrhea were unfavorable factors of the 6-month ABG. Using logistic regression for the 5-year analysis, malleus remained a significant predictor at 5 years. Those with malleus were 2.65 times more likely to be successful. Using ANOVA, absent malleus was the only significant unfavorable factor of postoperative ABG at 5 years. In the univariate analysis, absent stapes and revision surgery are regarded as possible unfavorable factors.

In the present study, the authors try to define the studied population (chronic otitis media) and the follow-up period (6 months and 5 years), and use logistic regression and ANOVA for statistical analysis. Absent malleus and otorrhea are important unfavorable factors for short-term outcome in ossiculoplasty (6 months), whereas absent malleus is the only important unfavorable factor for long-term outcome in ossiculoplasty (5 years).