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Updated: Jun 4, 2026
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Ear and further anatomic anomalies in children undergoing stapedotomy
Georgios Kontorinis1, Friedrich Goetz, Thomas Lenarz
1Department of Otorhinolaryngology, Hanover Medical University, Hanover, Germany. Kontorinis.Georgios@mh-hannover.de
Insights
Pediatric stapes fixation can involve coexisting ear malformations and systemic anomalies. High-resolution computed tomography (HRCT) may not detect ossicular fixation, necessitating intraoperative assessment.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Medical Imaging
Background:
- Stapes fixation is a condition affecting hearing.
- Understanding associated anomalies in children is crucial for diagnosis and management.
Purpose of the Study:
- To investigate clinical, intraoperative, and high-resolution computed tomography (HRCT) findings in pediatric stapes fixation patients undergoing stapedotomy.
Main Methods:
- Diagnostic assessment of 12 children (18 ears) who underwent stapedotomy between 2005 and 2008.
- Clinical and intraoperative evaluation.
- High-resolution computed tomography (HRCT) imaging.
Main Results:
- Coexisting ear malformations (malleus-incus anomalies, malleus-epitympanum fixation, absent stapedius tendon, small ear canal/auricle) were common.
- HRCT identified some inner ear anomalies but failed to detect ossicular fixation.
- Systemic anomalies (kyphoscoliosis, esophageal atresia, finger malformations) were found in 66.7% of patients.
Conclusions:
- Ear malformations frequently accompany pediatric stapes fixation.
- Intraoperative assessment of ossicular mobility is vital as HRCT may miss fixation.
- Consider genetic referral for pediatric stapes fixation cases with systemic dysplasias.
Purpose:
Aim of this study was to examine any stapes fixation-related clinical, intraoperative and high-resolution computed tomography (HRCT) findings in children undergoing stapedotomy.
Procedures:
Detailed diagnostic assessment was performed in 12 children (18 ears) who underwent stapedotomy within the period 2005-2008.
Results:
Ear malformations such as malleus-incus anomalies, malleus-epitympanum fixation and absence of the stapedius tendon, small external auditory canal and auricle malformations were clinically and/or intraoperatively diagnosed. HRCT identified a petrous high jugular bulb and malformed inner auditory canal in 4 ears; however, it failed to recognize ossicular fixation. Systemic anomalies, namely kyphoscoliosis, esophageal atresia and finger malformations were identified in 2 children. Summing up, additional anatomic anomalies were found in 8 patients (66.7%).
Conclusions:
Ear malformations may coexist in children with stapes fixation. Ossicular fixation is not easily recognized with HRCT, and therefore, ossicular mobility should always be tested intraoperatively. In a few cases, pediatric stapes fixation can coexist with systemic dysplasias; in such patients, additional referral to geneticists is recommended.
