NDLI: Hearing Outcomes after Revision Stapedectomy Managed with Total Ossicular Prostheses.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lupo, J. Eric Strickland, Brian M. House, John W.
Description	Country affiliation: United States Author Affiliation: Lupo JE ( House Ear Clinic, University of Southern California Keck School of Medicine, Los Angeles, California, USA.); Strickland BM ( University of Southern California Keck School of Medicine, Los Angeles, California, USA.); House JW ( House Ear Clinic, University of Southern California Keck School of Medicine, Los Angeles, California, USA University of Southern California Keck School of Medicine, Los Angeles, California, USA jhouse@houseclinic.com.)
Abstract	OBJECTIVES: (1) To describe the use of total ossicular prostheses (TOPs) in the setting of stapedectomy requiring an incus bypass procedure. (2) To analyze the short- and long-term audiometric results of TOP utilization in the setting of stapedectomy for an incus bypass procedure. STUDY DESIGN: Case series with chart review. SETTING: Tertiary neurotologic referral center. SUBJECTS AND METHODS: Seventeen cases of TOP reconstruction after stapedectomy were performed due to advanced incus erosion. The cases were assessed for pre- and postoperative bone conduction and air conduction pure-tone averages (PTAs; 0.5, 1, 2, 3 kHz), including high-tone bone conduction (1, 2, 4 kHz), air-bone gap, and speech discrimination scores. Hearing outcomes were measured: short-term (3 weeks) and long-term (average, 22 months). RESULTS: Among 17 ears undergoing revision stapedectomy managed with TOP reconstruction, the average number of previous revision attempts was 1.0 (SD, 1; range, 1-5). The preoperative bone conduction PTA was 30.7 dB preoperatively, while the preoperative air conduction PTA was 64.3 dB. The mean postoperative air-bone gap significantly decreased to 18.9 dB (SD, 12.7; range, 5-46.25; P < .003) with a mean follow-up of 22.2 months (SD, 25.0; range, 0.75-78). No significant decrement in high-tone bone conduction PTA was observed (mean, 0 dB; SD, 12.8; range, -36.7 to 20; P = .427); however, 1 ear revealed a severe decrease in PTA and speech discrimination score postoperatively. No further revisions were noted in follow-up. CONCLUSION: TOP reconstruction in the setting of previous revision stapedectomy with limited incudovestibular reconstructive options may lead to favorable hearing outcomes, but it carries an increased risk of sensorineural hearing loss.
File Format	HTM / HTML
ISSN	01945998
Issue Number	6
Volume Number	153
e-ISSN	10976817
Journal	Otolaryngology -- Head and Neck Surgery
Language	English
Publisher	SAGE Publications
Publisher Date	2015-12-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Reoperation Adverse Effects Audiometry Humans Middle Aged Discipline Otolaryngology Male Treatment Outcome Hearing Loss, Sensorineural Journal Article Hearing Etiology Stapes Surgery Female Physiology Bone Conduction Postoperative Complications Speech Perception Ossicular Prosthesis Methods
Content Type	Text
Resource Type	Article
Subject	Otorhinolaryngology Surgery

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