Audiometric Outcomes Following Endoscopic Ossicular Chain Reconstruction

Objective: To evaluate the audiometric outcomes following endoscopic ossicular chain reconstruction (OCR). Study Design: Retrospective case series. Setting: Two tertiary referral centers. Patients: Sixty two ears with ossicular discontinuity. Intervention(s): Endoscopic and microscopic OCR in patients with ossicular discontinuity. Main Outcome Measures: Bone and air pure-tone averages (PTA), air-bone gap (ABG), and word recognition scores (WRS). Results: Sixty two ears were included for analysis. Patients that underwent ossiculoplasty were subdivided based on prosthesis type (total ossicular replacement prosthesis [TORP] and partial ossicular replacement prosthesis [PORP], primary and staged ossiculoplasties, and surgical approach [microscopic and total endoscopic]). Forty two ears required PORP reconstructions, while 20 ears required TORP reconstructions. The microscope was used to reconstruct the ossicular chain in 31 cases, while an exclusive endoscopic approach was used in the remaining 31 patients. Controlling for the prosthesis, there were no significant postoperative differences in bone PTA, air PTA, and ABG between primary and staged ossiculoplasties, or surgical approach. Conclusions: Controlling for the type of prosthesis, there were no significant differences in hearing outcomes with respect to staged ossicular chain reconstruction or whether the endoscope or microscope was used for visualization. Thus, in this series, endoscopic OCR yields similar audiometric outcomes when compared with microscopic OCR.