Comparative study of unilateral conductive hearing loss in patients with an intact tympanic membrane

Abstract

Background

The ossicular chain status is directly associated with the severity of conductive hearing loss (CHL) when the tympanic membrane (TM) is intact.

Aims/objectives

To analyze the relationship between intraoperative findings and audiological data in patients with unilateral CHL and an intact TM.

Material and methods

Forty-three patients who underwent surgery at Xinhua hospital from January 1, 2012, to December 31, 2019, were included and categorized based on their intraoperative findings. Demographic data, intraoperative findings, and preoperative and postoperative audiological results of these patients were analyzed.

Results

Patients with ossicular chain disruption had significantly better outcomes than those with ossicular chain fixation (air conduction threshold [ACT]: 26.51 ± 8.82 vs. 44.08 ± 14.41 dB, p < .01; air-bone gap [ABG]: 10.66 ± 6.47 vs. 18.91 ± 9.32 dB, p = .04). Patients with ossicular chain deformities had a higher ACT (56.95 ± 13.81 vs. 44.56 ± 15.44 dB, p = .048) and a larger ABG (43.17 ± 9.94 vs. 33.02 ± 13.41 dB, p = .047) preoperatively than those with cholesteatoma; however, the postoperative outcomes between both patient groups were similar.

Conclusions

Congenital ossicular chain anomalies had similar surgical outcome regardless of the pathology. In acquired cases, ossicular chain disruption had better audiological outcomes than ossicular chain fixation.

Significance

Ossicular chain reconstruction can significantly improve the hearing in patients with UCHL with intact TM.

Chinese abstract

背景：在鼓膜（TM）完好无损的情况下, 听骨链状态与传导性听力损失（CHL）的严重程度直接相关。

目的：分析单侧CHL而TM完好无损的患者的术中发现与听觉数据之间的关系。

材料和方法：本研究包括2012年1月1日至2019年12月31日在新华医院接受手术的43例患者。根据其术中发现, 对他们进行分类。分析了这些患者的人口统计学数据、术中发现以及术前和术后听力学结果。

结果：听骨链断裂的患者的结局明显优于那些听骨链固定术的患者（空气传导阈值[ACT]：26.51±8.82 vs. 44.08±14.41 dB, p <.01；气骨间隙[ABG]：10.66±6.47 vs. 18.91±9.32 dB, p¼.04）。听骨链畸形患者在术前具有比胆脂瘤患者更高的ACT（56.95±13.81 vs.44.56±15.44 dB, p¼.048）和更大的ABG（43.17±9.94 vs. 33.02±13.41 dB, p¼.047）；但是, 术后两组患者的结果相似。

结论：先天性听骨链异常具有相似的手术结局, 无论其病理如何。在获得性病例中, 听骨链断裂比听骨链固定具有更好的听觉效果。

意义：听骨链重建可显着改善单侧CHL而TM完好无损的患者的听力。

Keywords:

• Conductive hearing loss
• middle ear
• ossicular chain
• cholesteatoma

Acknowledgments

We would like to thank Editage (www.editage.cn) for English language editing.

Disclosure statement

The authors reported no potential competing interest.