{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:40:03Z","timestamp":1787031603074,"version":"build-2736575974"},"reference-count":0,"publisher":"Caleo","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Int Adv Otol."],"abstract":"<jats:p>Objective: Compare hearing benefit of incus preservation in primary cholesteatoma surgery versus cartilage-myringostapediopexy.\n\nMethods: Prospective cohort study in a tertiary referral center. Tympanoplasty utilizing cartilage or other grafts, with or without intact incus was performed in 195 ears (187 children) with intact stapes. Outcome measures were pre and post-operative four-tone air conduction (AC) threshold (0.5, 1, 2, 4 kHz) and proportion with normal hearing (AC \u2264 30 dB HL) at 12 months.\n\nResults: Ears with intact ossicles had better post-operative AC thresholds than those with incus eroded or removed (median 20 dB HL vs. 30 dB HL, Mann\u2013Whitney P &lt; .001). The normal hearing rate was 81\/106 (74%) with intact incus and 46\/89 (52%) without (Fisher\u2019s exact P\u2009=\u2009.001). Ears without intact incus and a cartilage-myringostapediopexy had better post-operative thresholds than those with a non-cartilage graft (28.8 dB HL vs. 36.3 dB HL, Mann\u2013Whitney P\u2009=\u2009.005). Of ears without intact incus, 37\/59 (63%) with a cartilage-myringostapediopexy and 9\/30 (30%) with a non-cartilage graft had normal hearing post-operatively (Fisher\u2019s exact P\u2009=\u2009.007). By preserving the incus in 12 ears, 1 more ear would have normal hearing than with incus removal plus cartilage-myringostapediopexy (NNT\u2009=\u200912 (CI 3.6-); Fisher\u2019s exact\u2009=\u20090.1).\n\nConclusion: Preserving an intact ossicular chain conveys a small but significant hearing benefit in cholesteatoma surgery, the magnitude of which should be considered before deciding to remove the intact incus. Cartilage-myringostapediopexy provides a significant gain in hearing when the incus is absent, even without a partial ossicular replacement prosthesis.\n\nCite this article as: Kimura E, Leonard C, James A. The effect of the status of the ossicular chain and choice of graft material on hearing outcomes in pediatric cholesteatoma surgery. J Int Adv Otol. 2021; 17(2): 127-33.<\/jats:p>","DOI":"10.5152\/jiao.2021.0090","type":"journal-article","created":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T03:44:58Z","timestamp":1618631098000},"page":"127-133","source":"Crossref","is-referenced-by-count":6,"title":["The Effect of the Status of the Ossicular Chain and Choice of Graft Material on Hearing Outcomes in Pediatric Cholesteatoma Surgery"],"prefix":"10.65717","volume":"17","author":[{"given":"Eiko","family":"Kimura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin G.","family":"Leonard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian L.","family":"James","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"55248","published-online":{"date-parts":[[2021,3,1]]},"container-title":["The Journal of International Advanced Otology"],"original-title":[],"link":[{"URL":"https:\/\/www.advancedotology.org\/index.php\/pub\/article\/download\/1449\/1447","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.advancedotology.org\/index.php\/pub\/article\/download\/1479\/1476","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.advancedotology.org\/index.php\/pub\/article\/download\/1479\/1476","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T10:44:11Z","timestamp":1769078651000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.advancedotology.org\/index.php\/pub\/article\/view\/1479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,1]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,4,14]]}},"URL":"https:\/\/doi.org\/10.5152\/jiao.2021.0090","relation":{},"ISSN":["2148-3817"],"issn-type":[{"value":"2148-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,1]]}}}