Document Detail


Total Ossiculoplasty in Children: Predictive Factors and Long-term Follow-up.
MedLine Citation:
PMID:  22183905     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the long-term results and predictive factors of a good outcome with the use of a total ossicular replacement prosthesis in children.
DESIGN: Retrospective case review.
SETTING: Tertiary referral center.
PATIENTS: The study included 114 children (116 ears).
INTERVENTIONS: A total of 116 ears underwent total ossicular chain reconstruction with a titanium prosthesis. Cartilage was always used for tympanic membrane reconstruction.
MAIN OUTCOME MEASURES: Audiological results were evaluated according to the guidelines of the American Academy of Otolaryngology-Head and Neck Surgery. Predictive factors of audiological results were determined. Logistic regression and χ(2) tests were used for statistical analysis.
RESULTS: The mean age at surgery was 9.8 years. Ossiculoplasty was performed during second-look surgery in 91 ears (78.4%) and during another stage in 25 ears (21.6%). The first-stage procedure was always performed for cholesteatoma. Audiometric results were available for 116 ears at 1 year, for 89 ears (76.7%) at 2 years, and for 42 ears (36.2%) at 5 years. Closure of the average air-bone gap (ABG) to within 20 dB was achieved in 65 ears (56%) at 1 year. The mean (SD) preoperative and postoperative (at 1 year) ABGs were 41.0 (9.5) dB and 22.4 (12.6) dB, respectively. There were no cases of extrusion, but 17 luxations of the prosthesis were confirmed by computed tomography. Luxation occurred on average at 31.4 months. Only three 4000-Hz degradations of bone conduction were reported, with no dead ears. We examined 3 predictive factors of auditory results: preoperative ABG, footplate status, and postoperative otoscopic findings.
CONCLUSIONS: Total ossiculoplasty is a reliable technique in children. Long-term hearing outcomes are stable and satisfactory, but luxation can occur at any time. Preoperative ABG and footplate status are negative predictive factors of auditory results.
Authors:
Jerome Nevoux; Antoine Moya-Plana; Pierre Chauvin; Francoise Denoyelle; Erea-Noel Garabedian
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  137     ISSN:  1538-361X     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1240-6     Citation Subset:  AIM; IM    
Affiliation:
Service d'Oto-Rhino-Laryngologie Pédiatrique et de Chirurgie Cervico-Faciale, Hôpital d'Enfants Armand-Trousseau, 26 Ave du Dr Arnold Netter, 75012 Paris, France. jerome.nevoux@trs.aphp.fr.
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