Endoscopic ossiculoplasty in traumatic conductive hearing loss with intact tympanic membrane: a five-year experience

J Laryngol Otol. 2024 Apr;138(4):398-404. doi: 10.1017/S002221512300186X. Epub 2023 Nov 30.

Abstract

Background: Exploratory tympanotomy in cases of traumatic ossicular disruption with intact tympanic membrane is crucial for both diagnostic and therapeutic purposes. Performing this procedure using the endoscope is gaining popularity. Hence, this study aimed to demonstrate varieties of ossicular pathology and their management in our institution.

Methods: A retrospective evaluation was conducted of 136 ears in patients with traumatic ossicular disruption with an intact tympanic membrane, who underwent endoscopic exploratory tympanotomy. A proposed algorithm was followed, to incorporate different traumatic ossicular possibilities. Assessment of hearing outcomes and surgical complications was performed six months post-operatively.

Results: Incudostapedial dislocation was the most commonly encountered type of traumatic ossicular disruption (35.3 per cent). Air conduction threshold improved significantly following endoscopic ossiculoplasty, from 50.9 ± 6.35 dB pre-operatively to 22.35 ± 3.27 dB post-operatively, with successful air-bone gap closure.

Conclusion: Endoscopic ear surgery is effective in the diagnosis and management of challenging cases of post-traumatic ossicular disruption with an intact tympanic membrane.

Keywords: Endoscopic ear surgery; intact tympanic membrane; ossiculoplasty; traumatic ossicular disruption.

MeSH terms

  • Ear Ossicles / surgery
  • Hearing Loss, Conductive / diagnosis
  • Hearing Loss, Conductive / etiology
  • Hearing Loss, Conductive / surgery
  • Humans
  • Ossicular Prosthesis*
  • Ossicular Replacement* / methods
  • Retrospective Studies
  • Treatment Outcome
  • Tympanic Membrane / surgery
  • Tympanoplasty / methods