Titanium ossicular chain reconstruction in single stage canal wall down tympanoplasty for chronic otitis media with mucosa defect

Purpose: To evaluate surgical outcomes for chronic otitis media with mucosa defect underwent titanium ossicular chain reconstruction (OCR) in single stage canal wall down tympanoplasty (CWD). Methods: A clinical retrospective study was performed on 83 cases of the chronic otitis media with mucosa defect and 123 ears with mucosa integrity according to intraoperative findings that underwent synchronous titanium OCR in single stage CWD form January 2012 to January 2018. Pre- and postoperative air conduction threshold (AC), air-bone gap (ABG) and ABG closure at 0.5, 1, 2, and 4 kHz were investigated. Results: The overall mean AC threshold of 53.4 +/- 16.5 dB was lowered to 41.2 +/- 15.9 dB postoperatively (p < 0.01). The mean pre- and postoperative ABG of all patients were 27.9 +/- 9.9 dB and 17.2 +/- 9.3 dB (p < 0.01), respectively, with a mean ABG closure of 10.7 +/- 8.4 dB. The total rate of success, postoperative ABG < 20 dB was achieved in 71.4%. In the mucosa defect group underwent TORP, the mean pre- and postoperative ABG were 28.1 +/- 9.8 dB and 20.1 +/- 9.0 dB (p < 0.01), respectively, with the ABG closure was 8.0 +/- 7.9 dB. In the mucosa defect group underwent PORP, the mean pre- and postoperative ABG were 27.9 +/- 10.1 dB and 16.5 +/- 9.1 dB (p < 0.01), respectively, with the ABG closure was 11.4 +/- 8.6 dB. Furthermore, in the mucosa defect group, there was significant difference in success rate of achieved postoperative ABG 20 dB between the TORP (48.9%) and PORP (77.5%) (p < 0.05). Conclusion: It is revealed PORP in single stage CWD tympanoplasty for the patients suffered from chronic otitis media with mucosa defect is favored.