Audiometric results of tympanoplasty with stapedectomy and synthetic total ossicular replacement prosthesis: A STROBE analysis.

Aim: To evaluate the audiometric results of tympanoplasty with stapedectomy and insertion of a synthetic total ossicular replacement prosthesis (TORP).

Material and methods: Retrospective observational study conducted on a cohort of 15 patients (16 ears) aged 10 to 58 years (mean: 36 years) with chronic otitis media (COM) and tympanosclerosis (n=9), stapediovestibular ankylosis (n=3), minor aplasia (n=3) or post-traumatic ossicular dislocation (n=1). Treatment consisted in tympanoplasty with stapedectomy and TORP placement by the same operator, between December 1, 2012 and January 30, 2023, in a French university hospital department, with follow-up ranging from 2 to 92 months (mean: 24 months). The primary endpoint was postoperative change in air conduction (AC) threshold and air-bone gap (ABG). Secondary endpoints comprised change in speech recognition threshold (SRT) and speech discrimination score (SDS) and analysis of complications. The STROBE editorial line was followed and the significance threshold was set at P<0.005.

Results: There was significant improvement in AC threshold (-2 to 25dB, mean: 10dB; P=0.001), ABG (-8 to 26dB, mean: 10dB), SRT (2 to 30dB, mean: 13dB; P<0.0001) and SDS (P=0.001). No patients showed vestibular symptoms postoperatively.

Conclusion: This study suggests that this technique is a possible and safe therapeutic option in selected cases of stapes footplate fixation associated with other ossicular anomalies.