Partial Ossicular Replacement Versus Type II Tympanoplasty in Congenital Aural Atresia Surgery: A Matched Group Study

Abstract

Objectives: To compare partial ossicular replacement (POR) with type II tympanoplasty (T2) with regard to the postoperative hearing outcomes in patients with congenital aural atresia. Study Design: A retrospective review of medical records. Setting: Tertiary referral center. Patients: Thirty-four ears undergoing POR were compared with matched 34 ears by age at operation, grade of microtia, and the Jahrsdoerfer grading scale score that underwent T2. Methods: The medical records of the patients that underwent surgery for congenital aural atresia were reviewed. Main Outcome Measures: The preoperative and postoperative air-conduction threshold, air-bone gap, and air-bone gap closure were compared between the 2 groups. Results: Thirty-four ears in each group were compared. PORs were performed in cases of a incudostapedial joint problem, ossicular anomaly, or ossicular fixation. The preoperative and 6-month postoperative mean air-conduction thresholds and air-bone gaps were not significantly different in the comparisons between the 2 groups. The mean values for the postoperative air-bone gap closure were not significantly different in the 2 groups. The hearing results 3 years after surgery were available in 13 patients in each group. In these patients, the mean values of the preoperative and the 3-year postoperative air-conduction threshold and air-bone gap were not statistically different in the 2 groups. However, the mean air-bone gap closure in the POR group was 28.6 +/- 10.2 dB hearing level compared with 19.0 +/- 12.9 dB hearing loss in the T2 group, which was statistically significant (p = 0.034). Conclusion: POR can be a good surgical option in cases of a poor incudostapedial joint connection, ossicular anomaly, or ossicular fixation.