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Long-term results using ossicular grafts

J B Farrior1, S W Nichols

  • 1University of South Florida, Tampa, USA.

The American Journal of Otology
|May 1, 1996
PubMed
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Autologous bone grafts used in chronic ear surgery offer stable hearing outcomes for Type III tympanoplasty over 10 years. However, Type IV tympanoplasty shows long-term hearing deterioration, primarily due to eustachian tube dysfunction.

Area of Science:

  • Otolaryngology
  • Surgical Reconstruction
  • Audiology

Background:

  • Autologous bone grafts were historically used for ossicular chain reconstruction in chronic ear surgery.
  • Biocompatible implants have gained popularity, leading to decreased use of bone grafts.
  • This study evaluates the long-term stability and hearing outcomes of autologous bone grafts.

Purpose of the Study:

  • To assess the long-term stability of autologous bone grafts in chronic ear surgery.
  • To compare hearing results between Type III and Type IV tympanoplasty using bone grafts.
  • To identify factors influencing the long-term success of ossicular reconstruction with bone grafts.

Main Methods:

  • Retrospective review of 115 cases using autologous bone grafts between 1971 and 1984.

Related Experiment Videos

  • Patients underwent either Type III (stapes arch present) or Type IV (stapes arch absent) tympanoplasty.
  • Follow-up duration ranged from a minimum of 2 years to over 10 years for 30 patients.

    • Main Results:

    • In Type III tympanoplasty, initial air/bone gap was 19.7 dB, improving to 19.2 dB at 10 years, with 50% achieving ≤15 dB.
    • Type IV tympanoplasty showed an initial air/bone gap of 26 dB, deteriorating to 29.3 dB at 10 years (28% achieving ≤20 dB).
    • Poor eustachian tube function and middle ear collapse were identified as primary causes of long-term failure.

    Conclusions:

    • Autologous bone grafts provide initial hearing results comparable to synthetic prostheses.
    • Hearing results remain stable for up to 5 years with autologous bone grafts.
    • Type III tympanoplasty demonstrates long-term stability, while Type IV shows deterioration, linked to eustachian tube function.