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Published on: May 23, 2021
Endoscopic revision surgery for ossicular chain reconstruction: intraoperative findings and functional outcomes
Juan Wang1, Yueying Wang1, Shubin Fang1
1Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University and Institute of Otorhinolaryngology, Guangzhou, 510080, PR China.
Purpose:
To report the intraoperative observations and hearing outcomes in patients undergoing endoscopic revision ossiculoplasty.
Methods:
A retrospective cohort of patients who had undergone revision ossiculoplasty were enrolled in this study. Intraoperative findings were documented. Follow-up visits were scheduled from 3 to 12 months post-surgery to assess hearing levels and record any potential complications.
Results:
Between April 2020 and May 2023, a total of 26 cases were enrolled, with 11 male patients represented. The mean age of the patients was 40.5 ± 9.4 years, ranging from 18 to 66 years. During the revision surgeries, various intraoperative findings were noted, including adhesive tissues affecting the activity of ossicular chain (observed in 37.0% of cases), tympanosclerosis of the ossicular chain (also in 37.0% of cases), dislocation of ossicular prosthesis (33.3%), erosion of the ossicular chain (33.3%), and identified cholesteatoma (11.1%). In terms of hearing outcomes, a significant improvement was observed. Overall, only 37.0% of patients achieved an air-bone gap of 20 dB or less, indicating the inferior outcome in revision ossiculoplasty.
Conclusions:
This study highlight the role of inflammatory responses (adhesion, tympanosclerosis), stapes erosion, and prosthesis dislocation, as contributing factors to the failure of primary tympanoplasty. Endoscopic revision ossiculoplasty emerges as a reliable and effective approach.
