Congenital Middle Ear Anomalies: Anatomical and Functional Results of Surgery

Quesnel, S.; Benchaa, T.; Bernard, Sophie; Moureau, François; Viala, P; Abbeele, Thierry Van Den; Teissier, Natacha

doi:10.1159/000380940

Cited by 19 publications

(25 citation statements)

References 14 publications

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Section: Postoperative Audiometric Outcomes In Subjects With Second Psupporting

confidence: 83%

“…Furthermore, significant improvements were observed in the AC-PTA, BC-PTA, and ABG 6 months after surgery (23.8 ± 13.2, 12.5 ± 9.4, and 11.3 ± 8.9 dB HL, respectively; p < 0.05; Figure 2). In total, 21 (87.5%) patients had achieved successful ABG closure (<20 dB HL) [19] at 6 months after surgery. Subjects with congenital ossicular anomalies who have undergone ossiculoplasty are routinely followed up until 12 months postoperation at our institution, but only 11 of 24 patients (45.8%) in the current case series were followed up until 12 months postoperation, probably due to subjective satisfaction and no further need to revisit the outpatients' clinic after 6 months postoperation.…”

Section: Postoperative Hearing Outcomesmentioning

confidence: 99%

“…Several studies reported achieving significant hearing gains by exploratory tympanotomy and ossiculoplasty in subjects with congenital ossicular anomalies [11,19,22,23]. The rate of successful ABG closure (<20 dB HL) achieved at 6 months postoperation in our study following exploratory tympanotomy and ossiculoplasty, i.e., 87.5%, is comparable to that of previous studies, which reported closure rates ranging from 56% to 70% [11,19,22,23]. Although four types of surgery were performed in our cohort (TORP, PORP, IFA, and malleostapedotomy), the small sample size in each group (except for the TORP group) prevented us from determining whether one type was superior to the others.…”

Section: Postoperative Audiometric Outcomes In Subjects With Second Pmentioning

confidence: 99%

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Beware of a Fragile Footplate: Lessons from Ossiculoplasty in Patients with Ossicular Anomalies Related to Second Pharyngeal Arch Defects

Han

Choe

Kim

et al. 2019

JCM

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Background and objectives: We review the intraoperative findings and postoperative outcomes of ossiculoplasty in subjects with second pharyngeal arch (SPA)-derived ossicular anomalies. We summarize potential intraoperative complications and recommend precautions that may reduce the risk of fracture. Materials and Methods: Twenty-four patients with SPA-derived ossicular anomalies were included, and pre- and postoperative audiometric results were compared. Results: The mean air conduction threshold (56.0 ± 12.4 dB HL) was significantly improved 1 month (27.6 ± 10.1 dB HL) and 6 months (23.8 ± 13.2 dB HL) after surgery (p < 0.001). The preoperative air–bone gap (ABG) (40.4 ± 7.4 dB HL) was significantly decreased at 1 month (15.1 ± 5.9 dB HL) and 6 months (11.3 ± 8.9 dB HL) postoperation. ABG closure was successful (<20 dB HL) in 21 (87.5%) patients 6 months after surgery. Intraoperative footplate fractures occurred in 3 of 24 patients. The fractures were managed successfully, and the ABG closure was successful in all cases. Conclusions: The stapes footplate is likely to be relatively thin in subjects with SPA-derived ossicular anomalies because the footplate is partially or totally derived from the SPA. Thus, a fragile footplate should be expected, and care is needed when handling the footplate. However, when complications are overcome, the audiological outcomes are excellent in most cases.

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Section: Postoperative Audiometric Outcomes In Subjects With Second Psupporting

confidence: 83%

Section: Postoperative Hearing Outcomesmentioning

confidence: 99%

Section: Postoperative Audiometric Outcomes In Subjects With Second Pmentioning

confidence: 99%

See 1 more Smart Citation

Beware of a Fragile Footplate: Lessons from Ossiculoplasty in Patients with Ossicular Anomalies Related to Second Pharyngeal Arch Defects

Han

Choe

Kim

et al. 2019

JCM

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“…Further comparison was made between these cases and those of ossicular malformation without CCs. Since Teunissen and Cremers [20] had published a large case series of 144 congenital ossicular anomalies in the early 1990s, a few subsequent studies provided dozens of additional cases to allow for a better understanding of this congenital defect [2,[21][22][23][24]. Based on the literature, the most common ossicular anomalies of discontinuity were absent or underdeveloped long process of the incus and the superstructure of the stapes.…”

Section: Discussionmentioning

confidence: 99%

“…It may occur independently or jointly with other ear anomalies, such as those of the outer ear and/or the inner ear [1]. The incidence of congenital ossicular anomalies is estimated at 1 in 10,000-20,000 newborns, and most cases are unilateral [2,3].…”

Section: Introductionmentioning

confidence: 99%

Concurrent Occurrence of Congenital Ossicular Anomaly and Localized Cholesteatoma: Series of 10 Cases

Zhao

Chen

Zhang

et al. 2020

ORL

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Objective: The objective of this study is to describe the clinical features, managements and outcomes of a rare coexistence of congenital ossicular anomaly and localized cholesteatoma. A literature review on these cases and each congenital disorder is also presented. Methods: A retrospective chart review was performed on patients diagnosed with congenital ossicular anomaly with concurrent localized cholesteatoma from 2008 to 2017. Clinical data of these patients were collected. Results: A total of 10 patients were identified. All patients presented with unilateral hearing loss. Pure-tone audiometry showed conductive hearing loss in all affected ears with an average air conduction (AC) threshold of 59 dB. High-resolution computed tomography scans of the temporal bone diagnosed ossicular anomaly for 90% (9/10); however, only 50% (5/10) had a diagnosis of localized cholesteatoma. A transcanal exploratory tympanotomy under the microscope was performed to discover whether the localized tinysized cholesteatoma around the ossicular chain did not have direct contact with the ossicular chain, which could be diagnosed as congenital cholesteatoma. We removed the localized cholesteatoma and reconstructed the ossicular chain in each patient. All localized cholesteatomas were found in the posterior-superior quadrant of the middle ear. Ossicular chain anom-alies were associated with the incus and/or the stapes in all cases. Hearing improvement was achieved in each of the 6 patients who were followed up postoperatively, with an average AC threshold of 35 dB. The clinical features of congenital ossicular anomaly with concurrent congenital cholesteatoma were compared with those of each congenital disorder. The pathogenesis of each condition was also discussed. Conclusions: Congenital ossicular anomaly with concurrent congenital cholesteatoma is rare. It shares similar clinical features with congenital ossicular anomaly occurring alone, therefore awareness should be raised for a possible concurrent congenital cholesteatoma which was easy to miss in the diagnosis (50%) by the radiologist. A patient's hearing level can be improved by removal of the cholesteatoma and reconstruction of the ossicular chain. Localized cholesteatoma does not usually show residuals or recurrence.

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Bilateral Congenital Ossicular Anomalies: Are the Anomalies Symmetric for Both Ears?

Yeon

Son

Sung

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo evaluate whether bilateral congenital ossicular anomalies (COAs) differ regarding ossicular anomalies and hearing loss severities between the ears of the individual.Study DesignRetrospective case review.SettingTertiary referral academic center.MethodsBetween March 2012 and December 2022, 7 consecutive patients (14 ears) with surgically confirmed bilateral COAs were included in the study. Preoperative pure‐tone thresholds, COA classification according to the Teunissen and Cremers system, surgical procedures, and postoperative audiometric results were compared between the 2 ears of each patient.ResultsThe median age of the patients was 11.5 (range: 6‐25) years. Both ears of each patient were categorized based on the same classification. Three patients possessed class III COAs and the other 4 had class I COAs. The interaural differences in preoperative bone and air conduction thresholds were within 15 dB for all patients. Differences in postoperative air‐bone gaps between ears were not statistically significant. The surgical procedures required for ossicular reconstruction were almost identical for both ears.ConclusionThe severity of ossicular abnormalities and hearing loss in patients with bilateral COAs were symmetrical between ears, thereby enabling prediction of the characteristics of the contralateral ear based on the findings observed in 1 ear. These symmetric clinical features can aid surgeons when operating on the contralateral ear.

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Congenital Middle Ear Anomalies: Anatomical and Functional Results of Surgery

Cited by 19 publications

References 14 publications

Beware of a Fragile Footplate: Lessons from Ossiculoplasty in Patients with Ossicular Anomalies Related to Second Pharyngeal Arch Defects

Beware of a Fragile Footplate: Lessons from Ossiculoplasty in Patients with Ossicular Anomalies Related to Second Pharyngeal Arch Defects

Concurrent Occurrence of Congenital Ossicular Anomaly and Localized Cholesteatoma: Series of 10 Cases

Bilateral Congenital Ossicular Anomalies: Are the Anomalies Symmetric for Both Ears?

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