FP02-3. OSSICULAR CHAIN CLASSIFICATION: USE IN REPORTING RESULTS OF OSSICULOPLASTY

Bruce Black (University of Queensland, Australia)

The status of the ossicular chain is commonly used in the course of reporting results in ossiculoplasty or as a guide to the prognosis of a case. The most commonly used technique is the Austin Group technique, based on the presence or absence of the malleus handle and the stapes superstructure (Group A: MH+, SSS+; Group B: MH+,SSS-;Group C: MH-, SSS+; Group D:MH-,SSS-). These groupings are commonly assessed preoperatively.

It is noted that the status of the chain commonly changes during the surgery, especially when removal of the malleus handle is required. Also, the Austin groups do not assess the relevance of a displaced/fixed/diseased malleus handle, or a similarly diseased stapes.

This paper studies the changes incurred to the chain during a series of 500 ossiculoplasty cases.

The changes that occurred during surgery, and the pathology that rendered the preoperative ossicular status invalid as a guide to the case outcome produced two conclusions.

For research into ossiculoplasty outcomes, the status of the chain reported should be that immediately prior to the chain reconstruction during surgery.

Because of the unique stapes footplate fixation situation, this situation demands a separate Group E status to denote the poorer prognosis when a fixed footplate is encountered at surgery.

* Contact person email: bruceblackmd@bigpond.com