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Exclusive endoscopic ossiculoplasty with autologous material: step-by-step procedure and functional results

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To describe the surgical procedure of exclusive endoscopic ossiculoplasty (EEO) with autologous grafts and evaluate audiological results, focusing on the advantages or drawbacks compared to the corresponding microscopic technique.

Methods

A retrospective review of consecutive adult and pediatric patients affected by chronic otitis media (COM) with or without cholesteatoma who underwent EEO was conducted. Only autologous ossiculoplasty was included in the study. The procedure was performed by experienced surgeons of our institution between November 2014 and September 2019. Hearing outcomes were evaluated using postoperative air–bone gap (ABG) and success rates in different subgroups of patients and different types of ossiculoplasty (OPL) were analyzed. Our results were finally compared with the existing literature regarding both microscopic and endoscopic ossicular chain reconstruction.

Results

In total, 74 endoscopic ossicular chain repair procedures performed within the study period met the inclusion criteria. Of these, 21 were pediatric patients (28%) and 53 were adults (72%). Surgical reconstruction procedures included 43 partial ossicular reconstructions (POR) and 31 total ossicular reconstructions (TOR). The postoperative ABG improved significantly compared to preoperative measurements, and the mean ABG closure was 7.85 dB HL (p = 0.00064). No statistically significant differences in audiological outcomes between TOR/POR techniques and pediatric/adult groups were found in our study cohort, with p values of 0.10 and 0.88, respectively.

Conclusions

At present, EEO can be considered a valid surgical option for re-establishing a functioning ossicular chain with acceptable hearing restoration in children and adults. Further reports in wider case series are required to confirm these results.

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Data availability

The data supporting the findings of this paper are available and can be provided if requested.

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Funding

This study was not funded.

Author information

Authors and Affiliations

  1. Division of Otolaryngology, Head and Neck Surgery Department, University Hospital of Verona, Piazzale L. A. Scuro 10, 37134, Verona, Italy

    Davide Soloperto, Elisa Laura, Raffaele Cerullo, Riccardo Nocini & Gabriele Molteni

  2. Otolaryngology-Head and Neck Surgery Department, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy

    Luca Gazzini

  3. Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy

    Giuseppe Ferrulli & Daniele Marchioni

Authors
  1. Davide Soloperto
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  2. Elisa Laura
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  3. Luca Gazzini
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  4. Raffaele Cerullo
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  5. Giuseppe Ferrulli
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  6. Riccardo Nocini
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Correspondence to Raffaele Cerullo.

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Soloperto, D., Laura, E., Gazzini, L. et al. Exclusive endoscopic ossiculoplasty with autologous material: step-by-step procedure and functional results. Eur Arch Otorhinolaryngol 280, 4869–4878 (2023). https://doi.org/10.1007/s00405-023-08005-w

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