Total Ossiculoplasty Outcomes with and without a Stapes Footplate Prosthesis

Abstract

Objectives: Compare audiologic outcomes of total ossicular replacement prosthesis (TORP) ossiculoplasty performed with and without the placement of a stapes footplate prosthesis (FPP). Methods: A retrospective chart review was performed to identify adult patients undergoing TORP ossiculoplasty by the same surgeon at a tertiary care center between 1998 and 2012. Indications for surgery included cholesteatoma, atelectasis/perforation, chronic otitis media, and glomus tumor. Patients with a history of stapes surgery on the ear of interest were excluded from the study. Results: A lower rate of prosthesis displacement and statistically better audiologic outcomes were seen in FPP patients. The pure-tone average air-bone gap (PTA-ABG) was closed to <20 dB in 69.8% (37/53) of patients in the study arm and 44.4% (48/108) of patients in the control arm ( P < .001). The PTA-ABG was decreased by an average of 19.3 dB ± 11.7 dB (standard deviation, SD) and 12.6 dB ± 11.0 dB (SD) in the study and control groups, respectively ( P = .0014). Conclusions: Use of the titanium stapes FPP during TORP ossiculoplasty was associated with a statistically significant advantage in short-term PTA-ABG closure and a higher rate of successful rehabilitation of conductive hearing loss in this study. A lower rate of prosthesis displacement was seen in the FPP group, but further studies and longer follow-up periods are needed to validate this observation.