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Related Concept Videos

The Auditory Ossicles01:11

The Auditory Ossicles

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Related Experiment Video

Updated: Dec 10, 2025

Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
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Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration

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Do high-frequency air-bone gaps persist after ossiculoplasty?

Marc D Polanik1,2,3, Danielle R Trakimas4, Melissa Castillo-Bustamante1

  • 1Eaton-Peabody Laboratories Massachusetts Eye and Ear Infirmary Boston Massachusetts USA.

Laryngoscope Investigative Otolaryngology
|September 1, 2020
PubMed
Summary

Ossiculoplasty improves air-bone gap (ABG) hearing outcomes, but gains are greater at low frequencies than high frequencies. Current reporting may miss persistent high-frequency ABG after otologic surgery.

Keywords:
conductive hearing losshearing losshigh‐frequency hearing lossmiddle ear reconstructionossiculoplasty

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Area of Science:

  • Otolaryngology
  • Audiology
  • Surgical Outcomes

Background:

  • Conventional reporting of postoperative hearing outcomes using pure-tone averaged air-bone gap (ABG) is biased toward low frequencies.
  • This bias can lead to high-frequency ABG after otologic surgery going unnoticed.

Purpose of the Study:

  • To evaluate changes in low- and high-frequency ABG following ossiculoplasty.
  • To determine if current reporting methods adequately capture high-frequency hearing changes.

Main Methods:

  • Retrospective review of patients undergoing ossiculoplasty at a single tertiary care center.
  • Analysis of pre- and postoperative audiograms to calculate low-frequency (250, 500, 1000 Hz) and high-frequency (4 kHz) ABG.
  • Comparison of low- and high-frequency ABG improvements.

Main Results:

  • Ossiculoplasty significantly improved both low-frequency ABG (11.9 dB, P < .0001) and high-frequency ABG (5.9 dB, P = .030).
  • Low-frequency ABG closure was significantly greater than high-frequency ABG closure (P = .007).
  • Mean postoperative persistent high-frequency ABG was 22.0 ± 13.8 dB.

Conclusions:

  • Ossiculoplasty benefits hearing across frequencies, but high-frequency gains are less pronounced.
  • Current reporting standards may fail to identify persistent high-frequency ABG.
  • Further research is needed to optimize high-frequency hearing outcomes in ossiculoplasty.