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Congenital ossicular anomalies.

Kuang-Liang Hung¹, Tzong-Yang Tu, Tung-Lung Tsai

¹Department of Otolaryngology, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.

Journal of the Chinese Medical Association : JCMA

|November 8, 2003

Summary

Congenital ossicular anomalies, often involving the stapes, can be classified using Cremers

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Area of Science:

Otology and Neurotology
Surgical Anatomy
Medical History

Background:

Congenital ossicular anomalies encompass variations in the single or multiple ossicles of the middle ear.
These anomalies can present as isolated defects or complex malformations involving multiple ossicles.

Purpose of the Study:

To report on patients with congenital ossicular anomalies who underwent exploratory tympanotomy.
To correlate the surgical findings with Cremers' classification system for ossicular anomalies.

Main Methods:

Retrospective review of chart records for patients with congenital ossicular anomalies who underwent exploratory tympanotomy between 1993 and 2001.
Analysis of pre-operative hearing assessments, intra-operative findings, reconstructive procedures, and post-operative hearing outcomes.

Main Results:

Seventeen ears with congenital ossicular anomalies were analyzed.
The stapes was the most commonly affected ossicle, seen in isolated anomalies (35.3%) and combined anomalies (47%).
Distribution across Cremers' classification: 3 in Class 1, 6 in Class 2, 5 in Class 3, and 3 in Class 4. Post-operative air conduction improvement averaged 28.7 dB.

Conclusions:

Congenital ossicular anomalies frequently coexist with middle and inner ear abnormalities.
Ossicular reconstruction can improve hearing in select patients.
Cremers' classification effectively categorizes operative findings and guides reconstruction, with stapes status potentially indicating other anomalies.

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