Erosion of the long process of the incus with incomplete ossicular discontinuity in simple chronic otitis media: Should we reconstruct or leave it be?
Clin Otolaryngol
; 43(1): 300-305, 2018 02.
Article
in En
| MEDLINE
| ID: mdl-28872782
ABSTRACT
OBJECTIVE:
To determine whether patients with simple chronic otitis media and incomplete ossicular discontinuity should undergo ossicular reconstruction.DESIGN:
Prospective, randomised surgical trial comparing no intervention with incus interposition over a 5-year period.SETTING:
Tertiary referral hospital.PARTICIPANTS:
Seventy-six participants with simple chronic otitis media and erosion of the long process of the incus but apparent good transmission throughout the ossicular chain as tested intra-operatively. Forty-four patients had partial erosion of the incus but still bony contact with the stapes head (Group A-Type I), and 32 had mainly connective tissue binding the incus and stapes (Group B-Type II). Each of these groups was randomised to either leaving the ossicular chain as it was (A1 and B1) or performing an incus interposition (A2 and B2). MAIN OUTCOMEMEASURES:
Average postoperative air-bone gap and the degree of ABG closure. A postoperative air-bone gap under 20 dB was considered a successful result.RESULTS:
In group A, there was no significant difference between no intervention and incus interposition. In group B, patients in the no reconstruction subgroup had a significantly worse hearing result than the incus interposition subgroup (postoperative air-bone gap of 27.5 dB and 31% closure within 20 dB vs 15 dB and 75% closure).CONCLUSIONS:
For Type I patients, the postoperative hearing results were similar for the reconstruction and no reconstruction groups. For Type II patients, the results clearly favour reconstruction.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Otitis Media
/
Bone Conduction
/
Ossicular Prosthesis
/
Plastic Surgery Procedures
/
Decision Making
/
Hearing Loss, Conductive
/
Incus
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Year:
2018
Type:
Article