Ossicular chain reconstruction in children: Outcomes of autologous incus interposition and TORP

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-07-06 DOI:10.1016/j.ijporl.2025.112473

Aynur Aliyeva , Elvin Alaskarov

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引用次数: 0

Abstract

Aim

To compare hearing outcomes and prognostic factors in pediatric patients undergoing ossiculoplasty with autologous incus interposition (AII) or total ossicular replacement prosthesis (TORP).

Methods

This retrospective study included 102 children under 18 who underwent tympanoplasty with ossicular reconstruction between 2021 and 2024. Patients were divided into two groups based on reconstruction type (AII or TORP). Audiological outcomes were assessed at short-term (6–12 months) and middle-term (>12 months) follow-up. Air conduction (AC), bone conduction (BC), and air-bone gap (ABG) thresholds were measured. Multivariate logistic regression was used to identify predictors of ABG closure ≤20 dB.

Results

Among the 102 patients, 52 underwent AII, and 50 received TORP. At middle-term follow-up, ABG ≤ 20 dB was achieved in 72.5 % of AII patients versus 39.5 % in the TORP group (p = 0.003). AII patients also showed better AC thresholds (≤30 dB in 75.0 % vs. 57.9 %, p = 0.005) and greater hearing gain (13.1 ± 3.8 dB vs. 12.2 ± 4.3 dB, p = 0.028). Multivariate analysis identified intact stapes and AII use as independent predictors of success. Outcomes were also more favorable in cholesteatoma cases when the stapes were preserved.

Conclusion

AII offers superior middle-term hearing outcomes compared to TORP in pediatric ossiculoplasty. Stapes preservation and appropriate reconstruction technique selection are essential for optimal results.

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儿童听骨链重建：自体砧骨插入和TORP的结果

目的比较自体砧骨插入（AII）或全听骨置换术（TORP）患儿听骨成形术的听力结局和预后因素。方法本回顾性研究包括102例18岁以下的儿童，他们在2021年至2024年间接受了鼓室成形术和听骨重建术。根据重建类型（AII或TORP）将患者分为两组。在短期（6-12个月）和中期（12个月）随访时评估听力学结果。测量空气传导（AC）、骨传导（BC）和气骨间隙（ABG）阈值。采用多因素logistic回归确定ABG闭合≤20 dB的预测因素。结果102例患者中52例行AII， 50例行TORP。中期随访时，72.5%的AII患者达到ABG≤20db，而TORP组为39.5% （p = 0.003）。AII患者也表现出更好的交流阈值（75.0% vs. 57.9%, p = 0.005）和更高的听力增益（13.1±3.8 dB vs. 12.2±4.3 dB, p = 0.028）。多变量分析确定完整镫骨和AII是成功的独立预测因素。保留镫骨的胆脂瘤病例的结果也更有利。结论与TORP相比，aii在儿童听骨成形术中具有更好的中期听力效果。镫骨保存和选择合适的重建技术是获得最佳结果的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.