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Factors influencing hearing outcomes in pediatric patients undergoing ossicular chain reconstruction.

Abstract Ossicular chain disruption in children leads to conductive hearing loss. Few studies have focused on factors influencing successful results in pediatric ossicular chain reconstruction (OCR). We aim to determine whether demographic or surgical factors affect hearing outcomes in pediatric OCR.
PMID
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Authors

Mayor MeshTerms
Keywords

Conductive hearing loss

Ossicular chain reconstruction

Partial ossicular replacement prosthesis

Pediatric otolaryngology

Total ossicular replacement prosthesis

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 28688567
OWN - NLM
STAT- MEDLINE
DA  - 20170709
DCOM- 20170803
LR  - 20170803
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 99
DP  - 2017 Aug
TI  - Factors influencing hearing outcomes in pediatric patients undergoing ossicular
      chain reconstruction.
PG  - 60-65
LID - S0165-5876(17)30241-0 [pii]
LID - 10.1016/j.ijporl.2017.05.022 [doi]
AB  - OBJECTIVE: Ossicular chain disruption in children leads to conductive hearing
      loss. Few studies have focused on factors influencing successful results in
      pediatric ossicular chain reconstruction (OCR). We aim to determine whether
      demographic or surgical factors affect hearing outcomes in pediatric OCR.
      METHODS: We conducted a retrospective chart review of 120 patients undergoing OCR
      at our institution, a tertiary care hospital, between 2003 and 2014, with median 
      length of follow-up of 2.2 years (range 0.1-9.3 years). Pediatric patients (<18
      years old at time of surgical procedure) who had current procedural terminology
      (CPT) codes of OCR, and available pre- and post-operative audiograms were
      included in the study. Demographic information, surgical details, and pre- and
      post-operative pure-tone averages (PTA), speech reception thresholds (SRT), and
      air-bone gaps (ABG) were recorded from clinic notes, audiograms and operative
      reports. Differences between PTA, SRT and ABG pre- and post-operatively, as well 
      as demographic and surgical factors, were evaluated using Wilcoxon rank-sum
      tests. Factors influencing revision were evaluated using Log-rank tests. RESULTS:
      A total of 120 patients (123 ears) were included. 35.8% of cases were revised,
      most commonly due to displaced prostheses. 28.5% of surgeries resulted in normal 
      hearing (PTA </=25 dB) post-operatively. Post-operative SRT and ABG were
      significantly better in patients with partial ossicular replacement prosthesis
      (PORP) compared with those with total ossicular replacement prosthesis (TORP) (p 
      = 0.016, 0.027). Titanium prostheses resulted in better post-operative PTA and
      larger changes in PTA compared with all other materials (p = 0.034, p = 0.038).
      CONCLUSIONS: In our experience, children with titanium prostheses had better
      hearing outcomes than those with other materials, and children with PORP had
      better hearing outcomes than those with TORP.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Govil, Nandini
AU  - Govil N
AD  - Department of Otolaryngology, University of Pittsburgh Medical Center, Eye and
      Ear Institute, Suite 519, 203 Lothrop St, Pittsburgh, PA 15213, USA.
FAU - Kaffenberger, Thomas M
AU  - Kaffenberger TM
AD  - University of Pittsburgh School of Medicine, M240 Scaife Hall, 3550 Terrace St,
      Pittsburgh, PA 15261, USA.
FAU - Shaffer, Amber D
AU  - Shaffer AD
AD  - Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, 
      4401 Penn Ave, Pittsburgh, PA 15224, USA.
FAU - Chi, David H
AU  - Chi DH
AD  - Department of Otolaryngology, University of Pittsburgh Medical Center, Eye and
      Ear Institute, Suite 519, 203 Lothrop St, Pittsburgh, PA 15213, USA; Division of 
      Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn
      Ave, Pittsburgh, PA 15224, USA. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
DEP - 20170530
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
RN  - D1JT611TNE (Titanium)
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Ear Ossicles/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Hearing/physiology
MH  - Hearing Loss, Conductive/*surgery
MH  - Hearing Tests
MH  - Humans
MH  - Male
MH  - Ossicular Prosthesis/*adverse effects
MH  - Ossicular Replacement/*methods
MH  - Retrospective Studies
MH  - Titanium/therapeutic use
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Conductive hearing loss
OT  - Ossicular chain reconstruction
OT  - Partial ossicular replacement prosthesis
OT  - Pediatric otolaryngology
OT  - Total ossicular replacement prosthesis
EDAT- 2017/07/10 06:00
MHDA- 2017/08/05 06:00
CRDT- 2017/07/10 06:00
PHST- 2017/03/09 [received]
PHST- 2017/05/16 [revised]
PHST- 2017/05/27 [accepted]
AID - S0165-5876(17)30241-0 [pii]
AID - 10.1016/j.ijporl.2017.05.022 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2017 Aug;99:60-65. doi:
      10.1016/j.ijporl.2017.05.022. Epub 2017 May 30.