REPORTING OPERATIVE HEARING RESULTS - DOES CHOICE OF OUTCOME MEASURE MAKE A DIFFERENCE

Choice of outcome measure in reporting hearing results following otolo gic surgery, including the frequencies used and use of pre- or postope rative bone thresholds, varies from author to author. In this study, d ata from 550 ossicular reconstruction and pediatric tympanoplasty surg ery patients were used to generate a variety of outcome measures, incl uding pure-tone thresholds for frequencies from 0.5 kHz to 8 kHz and d ifferent frequency combination pure-tone averages (PTAs) and air-bone gaps. There were no significant differences between mean pre- and post operative bone conduction thresholds for any of the frequencies from 0 .5 to 4 kHz nor for a PTA of 1, 2, and 4 kHz. Mean postoperative air-b one gap differed by no more than 2 dB across six different frequency c ombination PTAs. If ''success'' is defined as a postoperative air-bone gap of less than 20 dB, the largest difference in success rate across the six frequency combinations was 5%. There was also little differen ce in mean postoperative air conduction PTAs for any of the combinatio ns that include frequencies through 4 kHz. Choice of a more conservati ve or more liberal definition of success was more important than wheth er air-bone gap or air conduction PTA was used. The authors recommend that a standard reporting procedure be adopted that ensures presentati on of the results in a format such that more direct comparisons can be made within the published literature.