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Related Experiment Video

Updated: Sep 5, 2025

Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
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Audiometric Outcomes Comparing Endoscopic Versus Microscopic Ossiculoplasty.

Mark Sakai1, Daniel E Killeen, Connie Ma

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|July 8, 2022
PubMed
Summary

Endoscopic ossiculoplasty using partial ossicular replacement prostheses (PORP) offers improved hearing outcomes compared to microscopic approaches. This study found endoscopic PORP ossiculoplasty resulted in a better air-bone gap (ABG).

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Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Audiology

Background:

  • Ossiculoplasty aims to restore hearing by reconstructing the middle ear ossicular chain.
  • Both endoscopic and microscopic techniques are utilized for ossiculoplasty, with varying reported outcomes.
  • Partial ossicular replacement prostheses (PORP) and total ossicular replacement prostheses (TORP) are common implant types.

Purpose of the Study:

  • To compare the audiometric outcomes of endoscopic versus microscopic ossiculoplasty.
  • To evaluate the effectiveness of partial ossicular replacement prosthesis (PORP) and total ossicular replacement prosthesis (TORP) in different surgical approaches.
  • To determine if surgical technique influences postoperative air-bone gap (ABG).

Main Methods:

  • Retrospective review of adult patients undergoing ossiculoplasty between 2010 and 2019.
  • Inclusion criteria required at least one year of audiometric follow-up.
  • Data collected included prosthesis type (PORP/TORP) and surgical approach (endoscopic/microscopic).

Main Results:

  • A total of 198 patients were analyzed, with a median follow-up of 27 months.
  • Overall median postoperative air-bone gap (ABG) was 16.9 dB.
  • Endoscopic partial ossicular replacement prosthesis (PORP) ossiculoplasty showed a significantly better median ABG (12.3 dB) compared to microscopic PORP (16.3 dB).
  • No significant difference in ABG was found between endoscopic and microscopic total ossicular replacement prostheses (TORP).

Conclusions:

  • Endoscopic partial ossicular replacement prosthesis (PORP) ossiculoplasty is associated with improved postoperative air-bone gap (ABG) compared to the microscopic approach.
  • The surgical technique may play a role in optimizing hearing results for specific ossiculoplasty reconstructions.
  • Further research may explore the long-term benefits and indications for endoscopic ossiculoplasty.