Ossiculoplasty Grading Scales and Outcomes - Reporting and Patient Counseling

Ossiculoplasty outcomes depend on anatomic reconstruction, middle-ear health, and patient perception of benefit, which depends partly on hearing status of the contralateral ear. Grading systems have evolved from simple anatomic staging to multivariable indices, culminating recently in the well-validated Ear Environment Risk (EER) score. EER best predicts postoperative hearing, with worse results after multiple revisions or tympanic membrane lateralization. Well-presented outcome studies follow American Academy of Otolaryngology-Head and Neck Surgery reporting guidelines, and convey hearing benefit more clearly by including Amsterdam benefit plots and patient-reported outcome measures. Good preoperative counseling requires integrating such predictors and outcomes with individual patient circumstances.