Outcomes After Exoscopic Versus Microscopic Ossicular Chain Reconstruction.

Authors

Caleb J. Fan
Jacob C. Lucas, Corewell Health
Robert M. Conway
Masanari G. Kato
Seilesh C. Babu, Corewell Health

Document Type

Article

Publication Date

12-1-2024

Publication Title

Otology & Neurotology

Abstract

OBJECTIVE: To analyze the outcomes of exoscopic versus microscopic ossicular chain reconstruction (OCR).

STUDY DESIGN: Retrospective chart review.

SETTING: Tertiary care otology-neurotology practice.

PATIENTS: Adult subjects with a diagnosis of ossicular discontinuity from 2018 to 2022.

INTERVENTIONS: Exoscopic or microscopic primary OCR (without mastoidectomy) with a partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP).

MAIN OUTCOME MEASURES: Audiometric outcomes at 3 months and 1 year postoperatively including bone and air pure tone averages (PTA), air-bone gap (ABG), change in ABG, speech reception threshold (SRT), and word recognition score (WRS). Secondary outcomes included operative time and complication rates of primary and delayed graft failure, tympanic membrane lateralization, prosthesis extrusion, cerebrospinal fluid leak, facial nerve injury, profound hearing loss, persistent tinnitus, and persistent vertigo.

RESULTS: Sixty ears underwent primary OCR and were subdivided based on prosthesis type (PORP and TORP) and surgical approach (exoscope vs microscope). Exoscopic OCR was performed on 30 ears (21 PORP, 9 TORP), and microscopic OCR was performed on 30 ears (19 PORP, 11 TORP). In the overall group (PORP + TORP) and in the PORP and TORP subgroups, there were no significant differences in 1) demographics, 2) intraoperative findings, and 3) audiometric outcomes of bone and air PTA, ABG, change in ABG, SRT, and WRS at 1 year postoperatively. Operative time was 64.7 and 59.6 minutes for the exoscopic and microscopic group, respectively ( p = 0.4, 95% CI [-16.4, 6.1], Cohen's D = 0.2).

CONCLUSIONS: Audiometric and surgical outcomes after exoscopic and microscopic OCR are comparable.

Volume

45

Issue

10

First Page

1135

Last Page

1142

Recommended Citation

Fan CJ, Lucas JC, Conway RM, Kato MG, Babu SC. Outcomes after exoscopic versus microscopic ossicular chain reconstruction. Otol Neurotol. 2024 Dec 1;45(10):1135-1142. doi: 10.1097/MAO.0000000000004326. PMID: 39284024.

DOI

10.1097/MAO.0000000000004326

ISSN

1537-4505

PubMed ID

39284024