Ossiculoplasty in canal wall down mastoidectomy

• Published in: Otolaryngology-head and neck surgery Vol. 123; no. 1; pp. 30 - 33
• Main Authors: Berenholz, Leonard P., Rizer, Franklin M., Burkey, John M., Schuring, Arnold G., Lippy, William H.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Elsevier Inc 01-07-2000; SAGE Publications
• Subjects: Audiometry, Pure-Tone; Auditory Threshold - physiology; Bone Conduction - physiology; Cholesteatoma, Middle Ear - surgery; Follow-Up Studies; Humans; Mastoid - surgery; Ossicular Replacement - methods; Otitis Media - surgery; Postoperative Complications - diagnosis; Postoperative Complications - physiopathology; Recurrence; Reoperation; Retrospective Studies; Tympanoplasty - methods
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1067/mhn.2000.106404

Objective: The aim of this study was to evaluate the initial and longer term success of closing the air-bone gap (ABG) to 20 dB in ossiculoplasty with canal wall down mastoidectomy. Methods: This study was conducted at a private otologic practice. Patients included those who underwent ossiculoplasty from 1989 to 1996 with canal wall down mastoidectomy, whether primary or revision (33 from a total of 387 tympanomastoidectomies). Outcome measures included ABG closure, long-term hearing stability, mastoid appearance, extrusion, and sensorineural hearing loss. Results: Almost 64% of ABGs were closed to within 20 dB. The mean pure-tone average improvement was 12.3 dB. The mean PTA hearing decline in the years after surgery was slightly less than 1 dB/year. Conclusion: Hearing improvement with a stable long-term hearing result is possible with canal wall down mastoidectomy. The potential for hearing gain is greatest for patients having larger preoperative ABGs. (Otolaryngol Head Neck Surg 2000;123:30-3.)