Hearing following total ossicular chain reconstruction prosthesis with and without footplate shoe prosthesis

To examine the audiometric outcomes of a footplate shoe (FPS) in total ossicular chain reconstruction prostheses (TORP) compared to TORP without shoe.

Retrospective cohort study of patients who underwent TORP from 2010 to 2021 at a tertiary children's hospital. Patients without audiograms or unknown FPS status were excluded. Demographics, TORP indication, pure tone average (PTA) thresholds, and TORP revisions/replacements were recorded. Characteristics of patients with and without FPS were compared using exact logistic regression, t-test, Wilcoxon rank-sum, and log-rank tests.

Of 76 patients, 27 (36 %) were female, and median age was 9.9 years (range 2.5-22.0 years). FPS was present in 12 (16 %) cases. Mean pre-operative PTA was 49.4 dB (SD: 15.1 dB) (no FPS) and 47.1 dB (SD: 9.3 dB) (with FPS) (P = 0.62). The first post-operative median PTA (median 3 months following surgery) was 36.3 dB (range 13.8-101.3 dB) (no FPS) and 31.6 dB (range 16.9-56.3 dB) in FPS group (P = 0.24). At the second post-operative visit (median 30.5 months following first audiogram), PTA increased to 45.6 dB (SD: 18.1 dB) (no FPS) compared to the first postoperative visit (P = 0.001). However, PTA was stable in the FPS group at the second postoperative visit (mean 35.6 dB, SD: 22.0 dB) compared to the first postoperative visit (P = 0.50).

Surgical intervention, regardless of FPS status, demonstrates significant improvement in audiometric outcomes at the first post-operative visit. At the second post-operative, there were no differences in audiometric outcomes among the FPS group, while the no FPS group had worse audiometric outcomes.