Outcomes of ossicular disruption in traumatic facial paralysis: a case series

Acta Otolaryngol. 2021 Mar;141(3):222-225. doi: 10.1080/00016489.2020.1833081. Epub 2020 Nov 5.

Abstract

Background: As tympanotomy using the transcanal approach was a routine surgical technique for traumatic ossicular disruption, the efficacy of the posterior tympanum approach was rarely explored.

Aim: This study aimed to investigate whether the hearing outcomes improved after simultaneous ossiculoplasty and facial nerve decompression using the posterior tympanum approach compared with the transcanal approach.

Material and methods: The data of 11 patients who underwent ossiculoplasty and facial nerve decompression using the posterior tympanum approach and 21 patients who underwent ossiculoplasty via transcannal approach were analyzed.

Results: The average air-bone gap (ABG) of patients undergoing posterior tympanotomy showed a statistically significant improvement. Postoperative ABG within 20 dB was observed in 81.8% of patients in the posterior tympanum group and 76.2% of patients in the transcanal group. However, the ABG closure in the two groups was not statistically different.

Conclusions and significance: Simultaneous ossiculoplasty using the posterior tympanum approach was practical, and the hearing outcomes were promising for the patients with traumatic facial nerve paralysis and ossicular disruption.

Keywords: Traumatic ossicular disruption; facial nerve injuries; posterior tympanotomy; surgical timing.

MeSH terms

  • Adult
  • Audiometry, Pure-Tone
  • Auditory Threshold
  • Bone Conduction
  • Craniocerebral Trauma / complications
  • Ear Ossicles / injuries*
  • Ear Ossicles / surgery
  • Facial Nerve Injuries / complications
  • Facial Nerve Injuries / surgery*
  • Facial Paralysis / etiology
  • Facial Paralysis / surgery*
  • Female
  • Hearing*
  • Humans
  • Male
  • Middle Aged
  • Ossicular Prosthesis
  • Ossicular Replacement
  • Otologic Surgical Procedures / methods*
  • Tympanic Membrane / surgery*
  • Young Adult