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Ossicular chain mobilisation versus reconstruction in surgery for isolated malleus and/or incus fixation: systematic review and meta-analysis

Published online by Cambridge University Press:  05 October 2018

W L Crutcher ,
P Tassone  and
S Pelosi
W L Crutcher*
Affiliation:
Department of Otolaryngology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
P Tassone
Affiliation:
Department of Otolaryngology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
S Pelosi
Affiliation:
Department of Otolaryngology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
*
Author for correspondence: Dr William L Crutcher, 317 S 11th St, Philadelphia, PA 19107, USA E-mail: [email protected]
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Abstract

Objective

To compare post-operative audiometric outcomes for the two prevailing surgical approaches for isolated malleus and/or incus fixation: ossicular mobilisation with preservation of the ossicular chain, and disruption and reconstruction of the ossicular chain.

Methods

A search was conducted, in December 2016, of PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature articles written in English. Papers presenting original data regarding post-operative audiometric outcomes in patients who underwent surgical treatment for malleus and/or incus fixation with a mobile and intact stapes were included. A risk of bias assessment was performed on the 14 selected papers and a tier system was developed. Meta-analysis was accomplished by comparing pooled rates of surgical success by chi-square test and calculating odds ratios by logistical regression. Analysis was performed using Revman5 and R software.

Results and conclusion

Analysis of the literature revealed no differences in audiometric outcomes between ossicular chain mobilisation and ossicular chain reconstruction in patients with isolated malleus and/or incus fixation. A large, prospective study comparing both short- and long-term hearing results for ossicular chain mobilisation and ossicular chain reconstruction in this population may identify whether a difference in outcomes exists between the two approaches.

Keywords

Ear OssiclesIncusMalleusStapesAnkylosisSclerosisOtologic Surgical ProceduresAudiometry
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 10 , October 2018 , pp. 858 - 865
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr W L Crutcher takes responsibility for the integrity of the content of the paper

Presented as a poster at the Pennsylvania Association of Otolaryngology – Head and Neck Surgery Annual Scientific Meeting, 16 June 2017, Hershey, Pennsylvania, USA.

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