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Partial ossicular reconstruction in children: a review of 62 operations
R L Daniels1, F M Rizer, A G Schuring
1Warren Otologic Group, Ohio 44484, USA.
Insights
Ossicular reconstruction in children shows favorable hearing outcomes, with 77% achieving successful results within six months. Long-term success rates were maintained, demonstrating the efficacy of pediatric ossiculoplasty.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Audiology
Background:
- Limited published data exists on ossicular reconstruction outcomes in pediatric populations.
- Understanding the role and efficacy of ossiculoplasty in children is crucial for improving hearing restoration.
- Previous studies primarily focused on adult patients, necessitating pediatric-specific data.
Purpose of the Study:
- To evaluate the audiometric results of partial ossicular reconstruction in children.
- To compare the outcomes of different prosthesis types used in pediatric ossiculoplasty.
- To assess prosthesis extrusion rates and failure mechanisms in a pediatric cohort.
Main Methods:
- Retrospective review of 62 partial ossicular reconstructions in pediatric patients.
- Analysis of audiometric results, prosthesis extrusion, and revision failure mechanisms.
- Comparison of porous polyethylene partial ossicular replacement prosthesis (POP), Schuring ossicle cup (SOC), and modified Robinson prosthesis (MRP).
Main Results:
- Postoperative air-bone gaps ≤ 20 dB achieved in 77% of cases at 6 months.
- Successful hearing results maintained at 1 year (66%) and 2 years (63%).
- Porous polyethylene partial ossicular replacement prosthesis (POP) showed high success rates (78% at 1 year, 89% at 2 years); overall extrusion rate was ~3%.
Conclusions:
- Pediatric ossiculoplasty yields results comparable to adult studies, with similar principles applicable.
- Prosthesis type showed few significant differences in long-term stability.
- Ossicular reconstruction in children is a secondary goal, prioritizing a safe and stable ear environment.
Objective/Hypothesis:
The published experience and audiometric results with ossicular reconstruction in children are limited. To better understand the role of ossiculoplasty in children, audiometric results were examined for partial ossicular reconstructions performed on a pediatric population.
Study Design:
Retrospective.
Methods:
Sixty-two partial ossicular reconstructions performed on a pediatric population were reviewed for audiometric results, prosthesis extrusion rates, and mechanisms of failure at revision. Comparison of techniques and prosthesis types: porous polyethylene partial ossicular replacement prosthesis (POP), Schuring ossicle cup (SOC), and modified Robinson prosthesis (MRP) were also evaluated. Follow-up ranged from 6 to 72 months.
Results:
Six-month hearing results showed postoperative airbone gaps less than or equal to 20 dB in 77% of cases. Successful results at 1 and 2 years were retained in 66% and 63% of cases, respectively. Results for POPs at 1 and 2 years were 78% and 89%. Results for SOCs at 1 and 2 years were 61% and 55%. The overall extrusion rate was approximately 3%.
Conclusions:
These results compare favorably with those from other, mostly adult, studies. Comparison of prosthesis types revealed generally stable long-term results with few significant differences. Success with ossiculoplasty in children can be obtained by applying the same principles and approach to ossicular reconstruction as used in adults. Ossicular reconstruction in children remains a secondary goal after establishing a safe, dry, and stable ear. A discussion of techniques and comparative literature review are presented.
