Comparison of Hearing Results of Malleovestibulopexy and Total Ossicular Replacement Prosthesis for Chronic Otitis Media Patients With a Mobile Stapes Footplate

Objective: This study aimed to assess differences in hearing outcomes using the malleostapedotomy or malleovestibulopexy (MVP) and total ossicular replacement prosthesis (TORP) techniques in chronic otitis media patients with a mobile stapes footplate. Study Design: Case series with planned data collection. Setting: A university medical center. Subjects and Methods: In total, 27 patients with chronic otitis media at the Sixth Hospital affiliated with Shanghai Jiao Tong University, between January and October 2010, were included. All patients had destruction of incus and stapes superstructures and a mobile stapes footplate. In all patients, surgery was performed under general anesthesia by a retroauricular approach. After the lesions were removed completely, ossicular reconstruction was performed using 1 of the techniques. In all patients, pure-tone audiograms were assessed before and 12 months after surgery. Results: Thirteen patients underwent MVP surgery, whereas the other 14 cases received traditional TORP surgery. All patients showed improvements in functional hearing after surgery. Although the numbers of ears that had closure of the air-bone gap within 20 dB in the MVP group were not statistically significantly higher than those in the TORP group (Fisher's exact test, P > .05), the average postoperative gain of the MVP group was significantly higher than that of the TORP group (t test, P < .05). Conclusion: Functional hearing in chronic otitis media patients with a mobile stapes footplate was better in those who underwent MVP surgery than in those who underwent TORP surgery.