Comparative study of unilateral conductive hearing loss in patients with an intact tympanic membrane

Abstract

Background The ossicular chain status is directly associated with the severity of conductive hearing loss (CHL) when the tympanic membrane (TM) is intact. Aims/objectives To analyze the relationship between intraoperative findings and audiological data in patients with unilateral CHL and an intact TM. Material and methods Forty-three patients who underwent surgery at Xinhua hospital from January 1, 2012, to December 31, 2019, were included and categorized based on their intraoperative findings. Demographic data, intraoperative findings, and preoperative and postoperative audiological results of these patients were analyzed. Results Patients with ossicular chain disruption had significantly better outcomes than those with ossicular chain fixation (air conduction threshold [ACT]: 26.51 ± 8.82 vs. 44.08 ± 14.41 dB, p < .01; air-bone gap [ABG]: 10.66 ± 6.47 vs. 18.91 ± 9.32 dB, p = .04). Patients with ossicular chain deformities had a higher ACT (56.95 ± 13.81 vs. 44.56 ± 15.44 dB, p = .048) and a larger ABG (43.17 ± 9.94 vs. 33.02 ± 13.41 dB, p = .047) preoperatively than those with cholesteatoma; however, the postoperative outcomes between both patient groups were similar. Conclusions Congenital ossicular chain anomalies had similar surgical outcome regardless of the pathology. In acquired cases, ossicular chain disruption had better audiological outcomes than ossicular chain fixation. Significance Ossicular chain reconstruction can significantly improve the hearing in patients with UCHL with intact TM.