{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:34:53Z","timestamp":1761006893647,"version":"build-2065373602"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to evaluate the surgical outcomes of partial ossicular replacement prosthesis (PORP) and total ossicular replacement prosthesis (TORP) in class III congenital middle ear anomalies (CMEAs) based on stapes suprastructure integrity and to propose a refined Teunissen\u2013Cremers classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A tertiary academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010nine ears from 46 patients with class III CMEAs who underwent ossiculoplasty from 2012 to 2024 were included. Patients were categorized into the viable suprastructure group (26 ears), with intact or mildly dysplastic suprastructures requiring PORP, and the non\u2010viable suprastructure group (23 ears), with severely dysplastic or absent suprastructures requiring TORP. Exclusion criteria included revision surgeries, other types of CMEAs, and a follow\u2010up period of &lt;6 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preoperative demographics and hearing thresholds were comparable between groups. Postoperative air\u2013bone gap (ABG) closure within 10\u2009dB was significantly more frequent in the viable group (80.8%) compared to that in the non\u2010viable group (52.2%, <jats:italic>P<\/jats:italic>\u2009=\u2009.033). ABG closure within 20\u2009dB was achieved in 100% of the viable group and 91.3% of the non\u2010viable group (<jats:italic>P<\/jats:italic>\u2009=\u2009.215). Postoperative complications, including sensorineural hearing loss and prosthesis extrusion, were similar between groups (<jats:italic>P<\/jats:italic>\u2009&gt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ossiculoplasty with PORP in viable cases demonstrated better ABG closure compared to TORP in non\u2010viable cases. Further investigation is warranted to determine the influence of baseline hearing differences on these outcomes. A refined Teunissen\u2013Cremers classification, subdividing class IIIa into IIIa1 (viable) and IIIa2 (non\u2010viable) based on stapes suprastructure integrity, may improve prosthesis selection and prognostic assessment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1158","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T07:57:02Z","timestamp":1738828622000},"page":"1711-1716","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Class III Congenital Middle Ear Anomalies: Refining the Teunissen\u2013Cremers Classification Based on Stapes Suprastructure Viability"],"prefix":"10.1002","volume":"172","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0268-1896","authenticated-orcid":false,"given":"Eun\u2010Kyeong","family":"Yeon","sequence":"first","affiliation":[{"name":"Department of Pediatrics Chungnam National University College of Medicine Daejeon South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Heun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Chungnam National University College of Medicine Daejeon South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumin","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Chungnam National University College of Medicine Daejeon South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3101-6841","authenticated-orcid":false,"given":"Jin Woong","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Chungnam National University College of Medicine Daejeon South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200110000-00026"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200105000-00005"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2388-1"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2022.103658"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949310200807"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000923"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.1273"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819900489"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000380940"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2024.112071"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29482"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-5099-9"},{"key":"e_1_2_7_14_1","doi-asserted-by":"crossref","unstructured":"Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. American Academy of Otolaryngology\u2010Head and Neck Surgery Foundation Inc.Otolaryngol Head Neck Surg.1995;113:186\u2010187.doi:10.1016\/S0194\u20105998(95)70103\u20106","DOI":"10.1016\/S0194-5998(95)70103-6"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-022-07451-2"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2019.1685682"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003577"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2005.10.006"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000176173.94764.f5"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28526"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28074"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480802587846"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002393"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004050000300"},{"key":"e_1_2_7_25_1","first-page":"329","article-title":"Long\u2010term hearing results of one\u2010stage tympanoplasty for chronic otitis media","volume":"249","author":"Vartiainen E","year":"1992","journal-title":"Eur Arch Otrhinolaryngol"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/14992020400050014"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-0993-0_8"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.137"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2013.01.019"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/dvdy.23831"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003490"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000893"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.1158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:31:18Z","timestamp":1760956278000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.1158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,6]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/ohn.1158"],"URL":"https:\/\/doi.org\/10.1002\/ohn.1158","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"type":"print","value":"0194-5998"},{"type":"electronic","value":"1097-6817"}],"subject":[],"published":{"date-parts":[[2025,2,6]]},"assertion":[{"value":"2024-09-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}