ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Hearing outcomes after ossiculoplasty for cholesteatoma: A retrospective comparison of autologous versus prosthetic reconstructions.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo compare hearing outcomes between autologous and prosthetic ossiculoplasty in patients with cholesteatoma. PRIMARY ENDPOINT: Postoperative change in pure-tone average air-bone gap (ΔPTA-ABG) following ossicular chain reconstruction using either autologous materials (cartilage or incus interposition) or partial and total titanium prostheses.
methodsAnalyze of 312 adult patients who underwent tympanoplasty with ossiculoplasty for COM-C between 2015 and 2023 at a French university hospital, divided into two groups: autologous reconstruction (n = 192) and prosthetic reconstruction (n = 120). ΔPTA-ABG (500-3000 Hz) was the primary outcome, with secondary endpoints including air conduction thresholds at 250-4000 Hz. Audiometric data were collected pre- and postoperatively (≥ 6 months). Univariate and multivariate linear regression analyses adjusted for confounders such as prior ear surgery, surgical approach, and operative timing.
resultsNo significant difference in ΔPTA-ABG was found between autologous (3.3 ± 11.6 dB) and prosthetic (4.6 ± 13.0 dB) reconstructions (p = 0.37). Frequency-specific analysis showed a significant ΔABG difference only at 250 Hz (p = 0.02). Prosthetic reconstruction demonstrated greater improvement in air conduction thresholds at 250 Hz (p = 0.04), 500 Hz (p = 0.02), and 1000 Hz (p = 0.05), while no differences were observed at higher frequencies. Preoperative thresholds were worse in the prosthetic group (p = 0.009). Multivariate analysis confirmed the absence of additional predictors of ΔPTA-ABG variance.
conclusionDespite more advanced baseline disease in the prosthetic group, autologous and prosthetic ossiculoplasty were associated with comparable air-bone gap improvement. Given the residual confounding inherent to this retrospective design, these findings should be interpreted as comparable improvement rather than as proof of equivalence between reconstruction materials.
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