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Updated: Dec 15, 2025
Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
Published on: January 26, 2024
Endoscopic Optical Coherence Tomography for Evaluation of Success of Tympanoplasty
Joseph Morgenstern1, Martin Schindler2, Lars Kirsten2
1Department of Otorhinolaryngology-Head and Neck Surgery, Ear Research Center.
Objective:
After tympanoplasty, it is often challenging to differentiate between different causes of a remaining air bone gap (ABG). Optical coherence tomography (OCT) offers a new approach for combined morphologic and functional measurements of the tympanic membrane and adjacent parts of the middle ear. Thus, it provides valuable diagnostic information in patients with a reduced sound transfer after middle ear surgery.
Patient And Intervention:
A patient with history of tympanoplasty and a persistent ABG was investigated with endoscopic OCT before revision surgery.
Main Outcome Measures:
The oscillation behavior and the thickness of the reconstructed tympanic membrane was determined. The oscillation amplitudes of the inserted prosthesis were compared to a finite element model simulation and to the clinical findings and the audiometric data of the patient.
Results:
OCT measurements showed a reduced oscillation amplitude of the prosthesis while revealing an aerated middle ear and good coupling of the prosthesis. Transfer loss measured by OCT showed a similar progression as the ABG measured by pure-tone audiometry with a mean divergence of 4.45 dB.
Conclusion:
Endoscopic OCT is a promising tool for the evaluation of tympanoplasty outcome. It supports established otologic diagnostics and can help differentiating between different causes of conductional hearing loss.
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