{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T06:25:41Z","timestamp":1757312741151,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec><jats:title>Objective\/Hypothesis<\/jats:title><jats:p>Stapes surgery is occasionally complicated by an intraoperative tympanic membrane perforation (ITMP), traditionally indicating abortion of the procedure due to concerns for postoperative infection and sensorineural hearing loss (SNHL). This work examines outcomes and complications in completed primary stapes surgeries with and without ITMP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients diagnosed with otosclerosis between February 2008 and September 2017 at a tertiary otology referral center were reviewed retrospectively. Primary outcome measures were post\u2010operative air\u2010bone gap (ABG), air conduction and bone conduction pure tone averages, and post\u2010operative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Review revealed 652 primary stapes operations meeting inclusion criteria, of which ITMP occurred in 10. There were no significant differences in pre\u2010operative hearing metrics or demographic characteristics between ears with and without ITMP. There were also no significant differences in post\u2010operative ABG (6.4 vs. 8.0\u2009dB HL, <jats:italic>P<\/jats:italic> = .43) or change in ABG after surgery (\u221221.6 vs. \u221218.2\u2009dB, <jats:italic>P\u2009=<\/jats:italic> .34) between these two groups. Patients with ITMP were more likely to complain of post\u2010operative dysgeusia (30.0% vs. 5.3%, <jats:italic>P<\/jats:italic> = .015) but were no more likely to develop reparative granuloma, otitis media, or SNHL (<jats:italic>P<\/jats:italic>\u2009&gt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The first review of ITMP and hearing outcomes after stapes surgery is presented. Our findings suggest that it is likely safe and appropriate to proceed with primary stapes surgery and concurrent tympanoplasty in the presence of a small ITMP with minimal risk of infection, SNHL, or worsened hearing outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E2026\u2013E2030, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29452","type":"journal-article","created":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T13:48:23Z","timestamp":1613310503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes After Tympanic Membrane Perforation During Primary Stapes Surgery for Otosclerosis"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8828-3444","authenticated-orcid":false,"given":"Alexander L.","family":"Luryi","sequence":"first","affiliation":[{"name":"Department of Neurotology Michigan Ear Institute  Farmington Hills MI U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Schettino","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Pennsylvania  Philadelphia PA U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias M.","family":"Michaelides","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Rush University  Chicago IL U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8670-8792","authenticated-orcid":false,"given":"Seilesh","family":"Babu","sequence":"additional","affiliation":[{"name":"Department of Neurotology Michigan Ear Institute  Farmington Hills MI U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0439-9509","authenticated-orcid":false,"given":"Dennis I.","family":"Bojrab","sequence":"additional","affiliation":[{"name":"Department of Neurotology Michigan Ear Institute  Farmington Hills MI U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher A.","family":"Schutt","sequence":"additional","affiliation":[{"name":"Department of Neurotology Michigan Ear Institute  Farmington Hills MI U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"162","article-title":"Does otosclerosis occur only in the temporal bone?","volume":"20","author":"Wang PC","year":"1999","journal-title":"Am J Otol"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.2003.00675.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000197387.29534.26"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1974.00780030298013"},{"key":"e_1_2_7_6_1","first-page":"1","article-title":"Otosclerosis in Norway, a geographical and genetical study","volume":"324","author":"Hall JG","year":"1974","journal-title":"Acta Otolaryngol Suppl"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2017.11.006"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2017.11.003"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001212"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20772"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e31825f24ff"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-014-3014-6"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-196201000-00002"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812458401"},{"key":"e_1_2_7_15_1","unstructured":"Iowa Head and Neck Protocols. 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