Congenital Stapes Anomalies with Normal Eardrum
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Objectives. A non-progressive and conductive hearing loss with normal eardrum, but no history of trauma and infection, is highly suggestive of a congenital ossicular malformation. Among ossicular anomalies, stapes anomaly is the most common. The purpose of this study is to describe patterns of stapes anomaly and to analyze its surgical outcome with special reference to its patterns. Methods. We conducted a retrospective case review. The subjects comprised 66 patients (76 ears) who were decisively confirmed by the exploratory tympanotomy as congenital stapes anomalies without any anomalies of the tympanic membrane and external auditory canal. The preoperative and postoperative audiological findings, temporal bone computed tomography scan, and operative findings were analyzed. Results. There were 16 anomalous patterns of stapes among which footplate fixation was the most common anomaly. These 16 patterns were classified into 4 types according to the status of stapes footplate. Successful hearing gain was achieved in 51 out of 76 ears (67.1%) after surgical treatment. Conclusion. Footplate fixation was usually bilateral, whereas stapes anomalies associated with other ossicular anomaly were usually unilateral. The success of the surgical treatment of stapes anomaly might depend on its developmental status of the footplate. Stapes anomalies were detected without any fixed patterns, therefore, it is quite possible to detect a large variety of patterns in future.
Abstract
Objectives. A non-progressive and conductive hearing loss with normal eardrum, but no history of trauma and infection, is highly suggestive of a congenital ossicular malformation. Among ossicular anomalies, stapes anomaly is the most common. The purpose of this study is to describe patterns of stapes anomaly and to analyze its surgical outcome with special reference to its patterns. Methods. We conducted a retrospective case review. The subjects comprised 66 patients (76 ears) who were decisively confirmed by the exploratory tympanotomy as congenital stapes anomalies without any anomalies of the tympanic membrane and external auditory canal. The preoperative and postoperative audiological findings, temporal bone computed tomography scan, and operative findings were analyzed. Results. There were 16 anomalous patterns of stapes among which footplate fixation was the most common anomaly. These 16 patterns were classified into 4 types according to the status of stapes footplate. Successful hearing gain was achieved in 51 out of 76 ears (67.1%) after surgical treatment. Conclusion. Footplate fixation was usually bilateral, whereas stapes anomalies associated with other ossicular anomaly were usually unilateral. The success of the surgical treatment of stapes anomaly might depend on its developmental status of the footplate. Stapes anomalies were detected without any fixed patterns, therefore, it is quite possible to detect a large variety of patterns in future.
참고문헌 (21)
- House HP, "Congenital stapes footplate fixation:a preliminary report of twenty-three operated cases", Laryngoscope, 68(8), pp.1389~1402 (1958)
- Lindsay JR, "Histopathologic observations in so-called congenital fixation of the stapedial footplate", Laryngoscope, 70(12), pp.1587~1602 (1960)
- Gundersen T, "Congenital malformations of the stapes footplate", Arch Otolaryngol, 85(2), pp.171~176 (1967)
- Steele BC, "Congenital fixation of the stapes footplate", Acta Otolaryngol, (245), pp.1~24 (1969)
- Teunissen B, "Isolated congenital stapes ankylosis: surgical results in 32 ears and a review of the literature", Laryngoscope, 100(12), pp.1331~1336 (1990)
- Nandapalan V, "Isolated congenital stapes ankylosis: an embryologic survey and literature review", Am J Otol, 21(1), pp.71~80 (2000)
- Albert S, "Congenital stapes ankylosis: study of 28 cases and surgical results", Laryngoscope, 116(7), pp.1153~1157 (2006)
- Schlosser WD, "Further experiences with the diagnosis and surgical management of congenital mixed deafness", Laryngoscope, 74, pp.773~789 (1964)
- Hashimoto S, "Surgical treatment of 52 cases of auditory ossicular malformations", Auris Nasus Larynx, 29(1), pp.15~18 (2002)
- Committee on Hearing and Equilibrium, "Committee on hearing and equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss", Otolaryngol Head Neck Surg, 113(3), pp.186~187 (1995)
- Dass R, "Human stapes and its variations. II. Footplate", J Laryngol Otol., 80(5), pp.471~480 (1966)
- Yuen HY, "Computed tomography of common congenital lesions of the temporal bone", Clin Radiol, 58(9), pp.687~693 (2003)
- Raveh E, "Congenital conductive hearing loss", J Laryngol Otol, 116(2), pp.92~96 (2002)
- Hung KL, "Congenital ossicular anomalies", J Chin Med Assoc, 66(8), pp.474~479 (2003)
- Dornhoffer JL, "Stapedectomy for congenital fixation of the stapes", Am J Otol, 16(3), pp.382~386 (1995)
- Cremers CW, "Congenital stapes ankylosis by elongation of the pyramidal eminence", Ann Otol Rhinol Laryngol, 95(2), pp.167~168 (1986)
- Teunissen B, "Surgery for congenital stapes ankylosis with an associated congenital ossicular chain anomaly", Int J Pediatr Otorhinolaryngol, 21(3), pp.217~226 (1991)
- Kinsella JB, "Familial stapes superstructure fixation", J Laryngol Otol, 107(1), pp.36~38 (1993)
- Nandapalan V, "Isolated congenital stapes suprastructure fixation", J Laryngol Otol, 113(9), pp.798~802 (1999)
- Doi T, "Familial isolated stapes-pyramidal fixation by a bony bar with normal stapedius tendon", Arch Otolaryngol Head Neck Surg, 131(4), pp.349~352 (2005)
- Ching HY, "An unusual stapes", Surg Radiol Anat, 28(5), pp.474~476 (2006)