Transcanal endoscopic management of isolated congenital middle ear malformations

Abstract

Background

A few studies have reported transcanal endoscopic management of isolated congenital middle ear malformations (CMEMs).

Objective

The purpose of this study is to describe our surgical experience in endoscopic ear surgery for isolated CMEMs and evaluate the surgical effect of hearing reconstruction.

Methods

From January 2017 to January 2022, a retrospective study was performed on 36 patients (37 ears) with isolated CMEMs who all underwent endoscopic surgery. Demographic data, high-resolution computed tomography (HRCT) findings, intraoperative findings, surgical management and audiometric data were recorded.

Results

Anomalies were categorized according to the Teunissen and Cremers classification system: 8 ears were categorized as class I, 8 ears as class II, 19 ears as class III and 2 ears as class IV. The air conduction pure tone average (AC-PTA) of 37 cases was 61.5 ± 8.6 dB preoperatively and 29.6 ± 6.9 dB postoperatively (p < 0.001). The mean preoperative air-bone gap (ABG) significantly decreased from 43.1 ± 8.7 dB to 12.8 ± 5.5 dB postoperatively. 36 of 37 cases (97%) met the criteria for successful operation.

Conclusion

Isolated CMEMs are mainly manifested as aplasia of the stapes’ superstructure and dysplasia of the long process of the incus. Transcanal endoscopic surgery seems a safe technique for the management of isolated CMEMs.

Chinese Abstract

背景：一些研究报道了经耳道内镜治疗孤立性先天性中耳畸形 (CMEM)。

目的：本研究的目的是描述我们对于孤立性 CMEMs进行耳内镜手术的手术经历, 并评估听力重建的手术效果。

方法：2017年1月至2022年1月, 对36例（37 只耳朵）患有孤立性 CMEM患者进行了回顾性研究。他们都接受了内窥镜手术。记录了 人口统计学数据、高分辨率计算机断层扫描 (HRCT) 结果、术中发现、手术管理和听力数据。

结果：根据 Teunissen 和 Cremers 分类系统对异常状况进行了分类：I级8只耳, III级8只耳, III级19只耳, IV级2只耳。 37例气导纯音平均值（AC-PTA）术前为61.5±8.6 dB, 术前为29.6±6.9 dB术后 (p < 0.001)。 平均术前气骨间隙 (ABG) 从43.1 ± 8.7 dB 减至 术后12.8 ± 5.5 dB。 37 例中有 36 例 (97%) 符合成功手术的标准。

结论：孤立性CMEM主要表现为镫骨上部结构发育不全和砧骨长突发育不良。对于孤立性 CMEM, 经耳道内窥镜手术似乎是一种安全的管理技术。

Keywords:

• Congenital abnormalities
• middle ear
• endoscopic surgical procedures
• treatment outcome

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Key Projects of National Natural Science Foundation of Zhejiang Province; National Natural Science Foundation of China.