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Outcomes After Exoscopic Versus Microscopic Ossicular Chain Reconstruction.

Caleb J Fan1, Jacob C Lucas, Robert M Conway

  • 1Michigan Ear Institute, Farmington Hills, Michigan.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|September 16, 2024
PubMed
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Exoscopic and microscopic ossicular chain reconstruction (OCR) yield comparable hearing outcomes and surgical results. This study found no significant differences between the two surgical approaches for patients with ossicular discontinuity.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Audiology

Background:

  • Ossicular chain reconstruction (OCR) is a surgical procedure to restore hearing in cases of ossicular discontinuity.
  • Both exoscopic and microscopic approaches are utilized for OCR, each with potential advantages and disadvantages.
  • Comparative outcome data between exoscopic and microscopic OCR is essential for surgical decision-making.

Purpose of the Study:

  • To compare the audiometric and surgical outcomes of exoscopic versus microscopic ossicular chain reconstruction (OCR).
  • To evaluate the efficacy of partial ossicular replacement prosthesis (PORP) and total ossicular replacement prosthesis (TORP) in both approaches.

Main Methods:

  • Retrospective chart review of adult patients undergoing primary OCR between 2018 and 2022.

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  • Surgical approaches included exoscopic or microscopic OCR without mastoidectomy, using PORP or TORP.
  • Audiometric outcomes (PTA, ABG, SRT, WRS) were assessed at 3 months and 1 year postoperatively.

    • Main Results:

    • Sixty ears underwent primary OCR, with 30 in the exoscopic group and 30 in the microscopic group.
    • No significant differences were observed in audiometric outcomes (PTA, ABG, SRT, WRS) between exoscopic and microscopic OCR at 1 year.
    • Operative times were comparable between the exoscopic (64.7 min) and microscopic (59.6 min) groups.

    Conclusions:

    • Exoscopic and microscopic approaches demonstrate comparable audiometric and surgical outcomes for ossicular chain reconstruction.
    • The choice between exoscopic and microscopic OCR may not significantly impact functional hearing results.
    • Further research could explore patient-reported outcomes and long-term hearing preservation.