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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.

References

1Subotic, R, Mladina, R, Risavi, R. Congenital bony fixation of the malleus. Acta Otolaryngol 1998;118:833–6Google Scholar
2Vincent, R, Lopez, A, Sperling, NM. Malleus ankylosis: a clinical, audiometric, histologic, and surgical study of 123 cases. Am J Otol 1999;20:717–25Google Scholar
3Seidman, MD, Babu, S. A new approach for malleus/incus fixation: no prosthesis necessary. Otol Neurotol 2004;25:669–73Google Scholar
4Katzke, D, Plester, D. Idiopathic malleus head fixation as a cause of a combined conductive and sensorineural hearing loss. Clin Otolaryngol Allied Sci 1981;6:39–44Google Scholar
5Armstrong, BW. Epitympanic malleus fixation: correction without disrupting the ossicular chain. Laryngoscope 1976;86:1203–8Google Scholar
6Tos, M. Bony fixation of the malleus and incus. Acta Otolaryngol 1970;70:95–104Google Scholar
7Teunissen, E, Cremers, CW. Surgery for congenital anomalies of the middle ear with mobile stapes. Eur Arch Otorhinolaryngol 1993;250:327–31Google Scholar
8Harris, JP, Mehta, RP, Nadol, JB. Malleus fixation: clinical and histopathological findings. Ann Otol Rhinol Laryngol 2002;111:246–54Google Scholar
9Guilford, FR, Anson, BJ. Osseous fixation of the malleus. Trans Am Acad Ophthalmol Otolaryngol 1967;71:398–407Google Scholar
10Martin, C, Oletski, A, Prades, JM. Surgery of idiopathic malleus fixation. Otol Neurotol 2009;30:165–9Google Scholar
11Albu, S, Babighian, G, Trabalzini, F. Surgical treatment of tympanosclerosis. Am J Otol 2000;21:631–5Google Scholar
12Tierney, JF, Stewart, LA, Ghersi, D, Burdett, S, Sydes, MR. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials 2008;8:16Google Scholar
13Higgins, JP, Green, S, eds. Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0. Copenhagen: Cochrane Collaboration, 2011;section 7.7.7.3Google Scholar
14Cochrane Collaboration. Review Manager (RevMan), version 5.3 [computer program]. Copenhagen: Nordic Cochrane Centre, Cochrane Collaboration, 2014Google Scholar
15Kirkwood, BR, Sterne, JA. Essential Medical Statistics. Malden, MA: Blackwell Science, 2003;414,425Google Scholar
16Higgins, JP, Green, S, eds. Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0. Copenhagen: Cochrane Collaboration, 2011;section 9.5.2Google Scholar
17Sakalli, E, Celikyurt, C, Guler, B, Biskin, S, Tansuker, HD, Erdurak, SC. Surgery of isolated malleus fixation due to tympanosclerosis. Eur Arch Otorhinolaryngol 2015;272:3663–7Google Scholar
18Shea, JJ. Plastipore total ossicular replacement prosthesis. Laryngoscope 1976;86:239–40Google Scholar
19Goldenberg, RA, Emmet, JR. Current use of implants in middle ear surgery. Otol Neurotol 2001;22:145–52Google Scholar
20Sennaroglu, L, Gungor, V, Atay, G, Ozer, S. Manubrio-stapedioplasty: new surgical technique for malleus and incus fixation due to tympanosclerosis. J Laryngol Otol 2015;129:587–90Google Scholar
21Stankovic, MD. Hearing results of surgery for tympanosclerosis. Eur Arch Otorhinolaryngol 2009;266:635–40Google Scholar
22Emmett, JR, Shea, JJ. Surgical treatment of tympanosclerosis. Laryngoscope 1978;88:1642–8Google Scholar
23Çelik, H, Felek, SA, Islam, A, Arslan, N, Demirci, M, Haberal Can, I. The effect of mobility of ossicles and surgical approach on hearing results in patients with tympanosclerosis. Mediterr J Otol 2008;4:184–90Google Scholar