SHI Licai,FANG Lucheng,CHEN Shuainan, et al. Clinical analysis of transcanal endoscopic ear surgery for single congenital middle ear malformations[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2022, 52(7): 545-549.
Abstract：Objective: To describe the operative findings and analyze the surgical effect of endoscopic ear surgery for congenital middle ear malformations. Methods: From January 2017 to June 2021, a retrospective study was performed on 27 patients with congenital middle ear malformations who underwent endoscopic surgery. Demographic data, high-resolution computed tomography findings, intraoperative findings, surgical management and audiometric data were recorded. Results: Altogether 27 patients with congenital middle ear malformations were included, consisting of 3 cases unilateral mixed hearing loss with significant conductive hearing loss and 24 cases unilateral conductive hearing loss. Anomalies were categorized according to the Teunissen and Cremers classification system: 5 ears were categorized as class I, 6 ears as class II, 15 ears as class III and 1 ear as class IV. Prostheses used in surgery included 8 PORPs, 7 TORPs and 11 Pistons. One patient was type IV, with vestibular window atresia, facial nerve malformation, and malleostapedotomy was performed with lengthened 7mm Piston to reconstruct ossicular chain. The air conduction pure tone average was (62.1±8.3) dB HL preoperatively and (30.6±7.4) dB HL postoperatively (t=19.47, P<0.001). Fifteen cases (55.6%) acquired an air conduction hearing gain exceeding 30 dB HL. Mean air-bone gap (ABG) was (43.1±9.3) dB HL preoperatively and (13.4±5.2) dB HL postoperatively (t=16.75, P<0.001). Twenty-five cases (93%) showed a postoperative ABG of less than 20 dB after operation. Conclusion: Simple congenital middle ear deformity is mainly manifested as a listening bone chain deformity. The ear endoscopy alone for the diagnosis and treatment of congenital middle ear malformation has the advantages of a clear field of vision, accurate manipulation, no need for external ear canal or posterior ear incision, small wound, few complications, good postoperative hearing recovery.
