3.5 Hearing outcomes
There were significant improvements at 3-month follow-up in AC, 43.4dB
(17.7) Vs 36.2dB (17.4), p<0.001, BC, 20.3dB (12.3) Vs 17.6dB
(12.6), p<0.001, and ABG 21.8dB, (11.8) Vs 16.7dB (10.4),
p<0.001, compared to pre-operative hearing.
In the microsurgery group, there were statistically significant
improvements in AC, 42.7dB (17.7) Vs 36dB (17.2), p<0.001)),
BC, 19.8dB (12.3) Vs 16.7dB (12.4), p<0.001 and ABG (21dB
(11.8) Vs 16.9dB (10.4), p<0.001. In the TEES group there were
statistically significant improvements in AC, 44.8dB (16.8) Vs 36.8dB
(17.8), p<0.001, BC 21.2dB (11.4) Vs 19.5dB (12.9),
p<0.001, and ABG 23.6dB (10.4) Vs 16dB (10.40),
p<0.001.
When compared to the microscopic approach, there was no statistically
significant difference in improvement in AC, 6.7dB (19.2) Vs 8.0dB
(14.9), p=0.665, BC, 3.1dB (10.4) Vs 1.7dB (6.6), p=0.632 and ABG 4.0dB
(14.8) Vs 7.5dB (13.6), p=0.160 in those who underwent TEES.
73% of those in the microscopic group and 72% in the TEES group
achieved an ABG better than 20dB with no significant difference (p
=0.907). All variables including the use of different TM grafts and
ossiculoplasty materials made no significant difference to the AC, BC
and ABG (all comparisons p>0.05) across the whole cohort
and when hearing outcomes of the microscopic and TEES groups were
compared (see Table 3)
Nineteen of 157 patients were noted to have stapes dehiscence at the
time of operation. Both microscopic and TEES sub-groups achieved
improvements in AC, 6.2dB (16.8) Vs 7.2dB (18.1), p= 0.8, BC 1.6dB (5.4)
Vs 2.8dB (9.8), p= 0.62 and ABG, 4.6dB (15) Vs 5.2dB (14.4) and the
difference was not statistically significant (p= 0.85). This remained
true when comparing those approached microscopically and via TEES
(p>0.05) (see Table 4)
Of 79 patients (59 microscopic and 20 TEES) who were reviewed 12 months
post-ossiculoplasty, there were no significant changes in AC, BC, or ABG
when compared to 3 months (p> 0.05). (Table 3)