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Updated: Aug 5, 2026
Techniques of Endoscopic Ossiculoplasty
Published on: January 26, 2024
Conventional Reporting Standards Conceal High-Frequency Hearing Deficits After Favorable Ossiculoplasty
Michael B Gluth1,2, Ryan T Judd3
1Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Western Australia, Australia.
Objective:
To evaluate high-frequency hearing outcomes in ossiculoplasty cases having favorable pure-tone average outcomes within the reporting range set by current guidelines.
Study Design:
Retrospective cohort study.
Setting:
Multi-center tertiary care ossiculoplasty outcome registry.
Methods:
From 1679 registry cases, 499 ears with synthetic partial or total ossicular replacement prostheses and postoperative pure-tone average air-bone gap (PTA-ABG) ≤ 15 dB at 0.5, 1, 2, and 3 kHz were included (mean follow-up, 34.4 ± 35.7 months). Outcomes included postoperative 4-kHz ABG and frequency-specific preoperative to postoperative changes in ABG and air-conduction (AC) thresholds.
Results:
Mean postoperative PTA-ABG was 9.6 ± 3.7 dB. The mean 4-kHz ABG was larger (18.2 ± 10.9 dB) than ABGs at 0.5 to 3 kHz (P < .001). Despite meeting success criteria, 51.5% of ears had a 4-kHz ABG ≥ 20 dB and 26.7% had a 4-kHz ABG ≥ 25 dB. AC improvement decreased with increasing frequency; gains at 4 to 8 kHz were smaller than at 0.5 to 3 kHz (P < .001).
Conclusion:
Current PTA-based reporting can suggest ossiculoplasty has been successful while substantial high-frequency conductive deficits persist. Future modification of hearing outcome reporting standards for conductive hearing loss might benefit from consideration of ≥4-kHz outcomes.
