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)