Long-term Follow up and patient satisfaction after tympanoplasty with Titanium Clip-Prothesis

Abstract

Aim of the present study is to evaluate the long term results of ossiculoplasty using titanium clip prosthesis. A retrospective analysis with prospective follow-up has been done including for all patients who had a Clip-PORP implanted between the years 2002-2013. Following this, audiometric hearing results were measured with clinical examination including otoscopy and quality of life evaluation using Glasgow benefit inventory. 48 patients (51 ears, 29 men, 19 women, average age 44.1 years) received followed up after an average duration of 6.3 years. The overall air-bone-gap (0.5-4 kHz) decreased from 22.8 dB preoperatively to 14.6 dB postoperatively (p≤0.001). The most frequent indication for surgical treatment were cholesteatomas and recurrent cholesteatomas (52%), chronic inflammation of middle ear (12%), revision of radical mastoidectomy (8%) and disturbance in sound conduction after previous operation (14%). Tympanic membrane was closed in 47 times (92,2%), 4 times (7,8%) there was a defect. Clip-PORP was in situ 39 times (75%), protrusion and disposal were detected 6 times (11,8%) and 2 times (4%), respectively. However, 1 time (2%) the prothesis was lost or evaluation was not possible (3 times, 5,9%). The overall patient satisfaction and general subscale score after the treatment was beneficially evaluated. There was no change in social support score nore the physical health score. In summary, the ossicular chain reconstruction using titan Clip-PORP is safe and well established. Also in long-term analysis stable hearing results due to reduction of air bone gap are represented. The subjective quality of life is sustainable improved.