Multislice Spiral Computer Tomography Findings of Simple Congenital Middle Ear Malformations

Abstract

Background. Simple congenital middle ear malformations (SCMEMs) are a group of congenital ear malformations. The study aims to analyze the multi-slice spiral computer tomography (MSCT) manifestations of normal ears and SCMEM ears. Objectives. This study aimed to investigate the MSCT manifestations of normal ears and SCMEM ears and to evaluate the relationship between the SCMEM and the tympanic segment of the FNC pathway. Methods. This was a retrospective case-control study. Patients who were diagnosed with SCMEM were included in the SCMEM group. Patients with vertigo, pulsatile tinnitus, or other symptoms were included in the control group. MSCT examination and image processing of the ossicular chain, facial nerve canal, and related structures were performed and compared between the two groups. Results. There were 94 cases in the SCMEM group (125 ears) and 97 cases in the control group (190 ears). Sixty-three cases (67.0%) were unilateral malformations (36 right ears and 27 left ears). MSCT showed congenital stapes malformation in 107 ears (85.6%) and incus long process malformation in 84 ears (67.2%). Among these, simple stapes malformations were found in 41 ears (32.8%), simple incus malformation in 18 ears (14.4%), and stapes malformation complicated with incus malformation in 66 ears (52.8%). The distance between the facial nerve and lateral semicircular canal (FNC-LSC) in the SCMEM group was 1.30 ± 0.64 mm compared to 0.79 ± 0.11 mm in the control group (P < 0.001), and the distance between facial nerve canal and oval window (FNC-OW) was 0.67 ± 0.53 mm in the SCMEM group and 1.13 ± 0.18 mm in the control group (P < 0.001). Conclusion. SCMEM occurred mainly in ossicular chain abnormalities. MSCT clearly showed the slight structural changes in the middle ear and provided an accurate basis for preoperative diagnosis.

Endoscopic Findings on Facial Nerve Anatomy During Exclusive Endoscopic Stapedotomy: Clinical Considerations and Impact on Surgical Results

“…Kang et al demonstrated its widespread application by establishing the clinical significance of coronal MSCT multi-planar reconstruction in detecting a downward and inward shift of the tympanic segment of the FN covering the oval window in patients with simple middle ear malformations. 29 In terms of surgical complications, the finding that no FN injury occurred is consistent with what is reported in the literature, with an overall postoperative FN weakness of 0.8%. 30 Among other adverse events encountered in our series, 2 gushers out of 165 patients (1.2%) have been the ones of most concern.…”