Hearing following total ossicular chain reconstruction prosthesis with and without footplate shoe prosthesis

Abstract

Purpose

To examine the audiometric outcomes of a footplate shoe (FPS) in total ossicular chain reconstruction prostheses (TORP) compared to TORP without shoe.

Materials and methods

Retrospective cohort study of patients who underwent TORP from 2010 to 2021 at a tertiary children's hospital. Patients without audiograms or unknown FPS status were excluded. Demographics, TORP indication, pure tone average (PTA) thresholds, and TORP revisions/replacements were recorded. Characteristics of patients with and without FPS were compared using exact logistic regression, t-test, Wilcoxon rank-sum, and log-rank tests.

Results

Of 76 patients, 27 (36 %) were female, and median age was 9.9 years (range 2.5–22.0 years). FPS was present in 12 (16 %) cases. Mean pre-operative PTA was 49.4 dB (SD: 15.1 dB) (no FPS) and 47.1 dB (SD: 9.3 dB) (with FPS) (P = 0.62). The first post-operative median PTA (median 3 months following surgery) was 36.3 dB (range 13.8–101.3 dB) (no FPS) and 31.6 dB (range 16.9–56.3 dB) in FPS group (P = 0.24). At the second post-operative visit (median 30.5 months following first audiogram), PTA increased to 45.6 dB (SD: 18.1 dB) (no FPS) compared to the first postoperative visit (P = 0.001). However, PTA was stable in the FPS group at the second postoperative visit (mean 35.6 dB, SD: 22.0 dB) compared to the first postoperative visit (P = 0.50).

Conclusions

Surgical intervention, regardless of FPS status, demonstrates significant improvement in audiometric outcomes at the first post-operative visit. At the second post-operative, there were no differences in audiometric outcomes among the FPS group, while the no FPS group had worse audiometric outcomes.