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Surgical treatment of 52 cases of auditory ossicular malformations
Shigehisa Hashimoto1, Yutaka Yamamoto, Hitoshi Satoh
1Department of Otolaryngology, Niigata University, School of Medicine, Asahimachi 1, Niigata 951-8510, Japan. shigex@sb3.so-net.ne.jp
Objective:
The aim of this study was to determine the relationship between hearing improvements and the pathological conditions of auditory ossicular malformations.
Methods:
Fifty-two ears (49 patients) with auditory ossicular malformations without congenital aural atresia were studied. The classification of the pathological conditions was based on surgical findings. Group 1 showed defects in the incudo-stapedial (I-S) joint, Group 2, fixation of the stapes, Group 3, fixation of the malleus and incus and Group 4, defects in the I-S joint with fixation of the stapes. Hearing improvements at the final examination were designated as successful when both of the following were satisfied. (1) Air-bone gap was reduced to 20 dB or less. (2) Postoperative hearing gain exceeded 15 dB.
Results:
Successful hearing improvements after operations were achieved in 20 ears (95%) in Group 1, 21 ears (91%) in Group 2, three ears (75%) in Group 3 and two ears (50%) in Group 4. They were observed in 88% of all cases.
Conclusions:
Postoperative hearing improvements of auditory ossicular malformations yielded good results, particularly in Groups 1 and 2. In retrospect, the unsuccessful cases with fixation of the stapes would have been improved if stapedectomy were chosen rather than mobilization. In defects to the long process of Group 4, we wished to perform a reconstruction using the malleus attachment piston after small-fenestra stapedectomy with regard to the long-term hearing results.