RESUMEN
OBJECTIVES: To determine if the OOPS index is predictive of long-term hearing results after ossiculoplasty. STUDY DESIGN: Case series with retrospective chart review. SETTING: Tertiary care otology practice. PATIENTS: Adult and pediatric patients (3-88 years of age). INTERVENTIONS: Ossiculoplasty with cartilage tympanoplasty, with or without mastoidectomy. OUTCOME MEASURES: Primary outcome measures included short-term hearing results (pure-tone average air-bone gap [PTA-ABG] measured between 60 days and 1 year after surgery), long-term hearing results (PTA-ABG measured ≥5 years after surgery), and the rate of successful ABG closure to ≤20âdB. Secondary measures included the need for revision surgery, delayed tympanic membrane graft failure, worsening conductive hearing loss (after an initially satisfactory hearing result), and recurrence of cholesteatoma. RESULTS: There was no significant difference between adults and children for short-term hearing results (average post-op PTA-ABG was 18.9âdB vs. 19.8âdB, respectively; pâ=â0.544), long-term hearing results (average final PTA-ABG was 19.3âdB vs. 19.4âdB, respectively; pâ=â0.922), or rate of ABG closure to less than 20âdB (63.1% vs. 58.0%, pâ=â0.282). Spearman's rank-order correlation (ρ) identified a strong positive correlation between OOPS index score and average post-operative PTA-ABG (ρâ=â0.983; pâ<â0.001; 2-tailed), as well as average long-term PTA-ABG (ρâ=â0.950, pâ<â0.001; 2-tailed). CONCLUSIONS: The OOPS index makes it possible to accurately prognosticate hearing outcomes in adult and pediatric patients undergoing ossiculoplasty in both the short term and the long term.
Asunto(s)
Pérdida Auditiva Conductiva/cirugía , Audición/fisiología , Apófisis Mastoides/cirugía , Reemplazo Osicular/métodos , Timpanoplastia/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Audiometría de Tonos Puros , Niño , Preescolar , Colesteatoma del Oído Medio/cirugía , Femenino , Humanos , Persona de Mediana Edad , Periodo Posoperatorio , Pronóstico , Estudios Retrospectivos , Resultado del Tratamiento , Membrana Timpánica/cirugía , Adulto JovenRESUMEN
OBJECTIVES: To assess the impact of tobacco smoking on outcomes after ossiculoplasty. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care center. PATIENTS: Adult patients (16-88 yr of age) undergoing ossiculoplasty with cartilage tympanoplasty. OUTCOME MEASURES: Patients were classified as smokers (TOB) or nonsmokers (TOB). Comparisons were then made between these two groups with regard to early and late audiometric outcomes, rate of cure of conductive hearing loss, rate of successful graft healing, and incidence of complications after surgery. RESULTS: There was no significant difference between the two groups with regard to postoperative ΔPTA-ABG (change in pure-tone average air-bone gap) (-14.4âdB vs. -14.6âdB for TOB vs. TOB, respectively, pâ=â0.946) or final audiometric outcome (ΔPTA-ABGfinal) (-13.6âdB vs. -11.7âdB for TOB vs. TOB, respectively, pâ=â0.315), cure of conductive hearing loss, defined as closure of the PTA-ABG to ≤20âdB HL, at postoperative audiometry (75.0% [129/172] for the TOB group vs. 69.3% [52/75] for the TOB group, pâ=â0.355), late audiometry (71.4% [105/147] for the TOB group vs. 66.7% [44/66] for the TOB group, pâ=â0.483), or successful graft healing (99.4% in the TOB group vs. 98.7% in the TOB group, pâ=â0.544). However, complications were observed significantly (pâ=â0.0003) more often in the TOB group (34.7% [26/75]) than the TOB group (14.5% [25/172]). CONCLUSION: Smoking is not a significant risk factor for anatomic failure of cartilage tympanic membrane graft or worsened audiometric outcome after ossiculoplasty. However, complications were significantly more common in smokers, supporting the practice of primary tympanostomy tube placement at the time of ossiculoplasty.