Abstract

OBJECTIVE: This study aims to investigate the frequency of ossicular fixation or discontinuity, applied surgical procedures and prosthesis sizes, and their audiologic effects.

METHODS: This retrospective study included 95 patients (21 males, 74 females; mean age 37 years; range 11 to 67 years) with conductive hearing loss operated for exploration of etiology between June 2001 and May 2015. Patients were examined preoperatively with microscope and pneumootoscopy to determine ossicles and tympanic membrane mobility, and degree of their hearing loss was identified by audiometry. Patients were evaluated for ossicular fixation, dislocation, malformation, and other pathologic processes intraoperatively.

RESULTS: In terms of middle ear pathologies, 63.1% of patients had normal ossicular chain, 29.4% had ossicular discontinuity, 55.7% had otosclerotic stapes fixation 35.7% had sclerosis and hyaline, 27.3% had mucosal bridge, 4.2% had anterior malleolar ligament calcifications, 4.2% had facial nerve dislocation, 4.2% had previous ossiculoplasty, 2.1% had perilymph fistula, 1.05% had cholesteatoma and middle ear hemangioma. Rate of intraoperative complications was 29.4% including 16.8% for tympanic membrane tearing, 11.5% for chorda tympani severed, and 1.05% for drug allergy. Preoperative pure tone average revealed an air conduction of 59 dB, bone conduction of 23 dB, and air-bone gap of 36 dB.

CONCLUSION: Our study findings showed no correlation between hearing loss levels, tympanogram types, and types of middle ear pathology. Causes of hearing loss were otosclerosis and ossicular discontinuity. Reasons for ossicular dysfunctions such as fixation or discontinuity may be detected intraoperatively in most patients.