Classification of Congenital Middle Ear Anomalies Report on 144 Ears

1993 ◽  
Vol 102 (8) ◽  
pp. 606-612 ◽  
Author(s):  
E. Bert Teunissen ◽  
W. R. J. Cremers
Keyword(s):  
Middle Ear ◽  
Round Window ◽  
Ossicular Chain ◽  
Oval Window ◽  
University Hospital ◽  
Middle Ear Surgery ◽  
Severe Dysplasia ◽  
Class 1 ◽  
Stapes Footplate ◽  
Ear Anomalies

The surgical findings in 144 successive ears operated on for congenital conductive hearing loss were analyzed, and the results were evaluated in terms of hearing gain. All the patients underwent middle ear surgery at the University Hospital Nijmegen between 1964 and 1990. A classification system was developed to analyze the findings. Class 1 comprises ears with congenital isolated stapes ankylosis. Class 2 comprises ears with congenital stapes ankylosis in combination with a congenital anomaly of the ossicular chain. Class 3 comprises ears with congenital anomalies of the ossicular chain and at least a mobile stapes footplate. Class 4 comprises ears with aplasia or severe dysplasia of the oval window or round window.

Reporting and Description for Congenital Middle Ear Malformations to Facilitate Surgical Management

2018 ◽  
Vol 127 (10) ◽  
pp. 717-725 ◽  
Author(s):  
Feng Yang ◽  
Yang Liu
Keyword(s):  
Surgical Treatment ◽  
Middle Ear ◽  
Round Window ◽  
Ossicular Chain ◽  
Oval Window ◽  
Surgical Approaches ◽  
Type I ◽  
Different Types ◽  
Ear Malformations ◽  
Stapes Footplate

Introduction: The aim of this work was to report and describe the different types of congenital middle ear malformations in order to guide surgical treatment approaches and improve outcomes for affected patients. Methods: The authors reviewed patients with congenital middle ear malformations who received surgical treatment between September 2010 and March 2017. Patient characteristics, middle ear deformities, and surgical procedures were documented. Results: In this retrospective study, 35 patients were reviewed. A description of middle ear malformation was proposed that considers ear embryogenesis and focuses on stapes deformity, with the main purpose of facilitating surgical approach selection to reconstruct the ossicular chain. Patients were classified into 3 categories: type I (19 cases), mobile stapes footplate, which included type Ia with normal stapes suprastructure and type Ib with abnormal stapes suprastructure; type II (4 cases), fixed stapes footplate, which included type IIa with normal ossicular chain and type IIb with abnormal ossicular chain; and type III (12 cases), oval window bony atresia or aplasia, with or without round window atresia. Types II and III could have concomitant aberrant facial nerve. Different surgical approaches are described. Conclusions: The authors describe the different types of congenital middle ear malformations. This category description considers ear embryogenesis and is focused on stapes deformity. It may provide better understanding of disease development and guide modern hearing reconstructive surgery.

scholarly journals Factors that have an influence on bone conduction thresholds changes after otosurgery in the patients operated on due to the perforation of the tympanic membrane with the preserved ossicular chain

2017 ◽  
Vol 71 (4) ◽  
pp. 26-33
Author(s):  
Maciej Wiatr ◽  
Agnieszka Wiatr ◽  
Sebastian Kocoń ◽  
Jacek Składzień
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Negative Impact ◽  
Positive Impact ◽  
Round Window ◽  
Bone Conduction ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Study Objective

Introduction: The aim of the middle ear surgery is to eliminate abnormalities from the mucous, ensure the due airing of the postoperative cavity and reconstruct the sound-conducting system in the middle ear. Numerous reports can be found in literature on the changes to bone conduction as a consequence of middle ear surgery. Study objective: The aim of the work is to define the factors that affect bone conduction in the patients operated on due to the perforation of the tympanic membrane with the preserved and normal mobile ossicular chain. Material and method: A prospective analysis of patients operated on due to diseases of the middle ear in 2009–2012 was carried out. The cases of patients operated on for the first time due to chronic otitis media were taken into consideration. The analysis encompassed the patients who had undergone myringoplasty. The patients were divided into several groups taking into account the abnormalities of the mucous observed during otosurgery. Results: A significant improvement of bone conduction was observed in the patients with dry perforation, without other lesions in the middle ear. The appropriate pharmacological treatment before otosurgery in patients with permanent discharge from the ear resulted in significant bone conduction improvement. The elimination of granulation lesions turned out to be a positive factor for the future improvement of the function of the inner ear. Conclusions: The lack of abnormalities on the mucous of the middle ear (e.g. granulation,) and discharge has a positive impact on improvement of bone conduction after myringoplasty. Adhesions in the tympanic cavity, especially in the niche of the round window, have a negative impact on improvement of bone conduction in patients after myringoplasty.

Round window application of an active middle ear implant (AMEI) system in congenital oval window atresia

2015 ◽  
Vol 136 (1) ◽  
pp. 23-33 ◽  
Author(s):  
Shouqin Zhao ◽  
Shusheng Gong ◽  
Demin Han ◽  
Hua Zhang ◽  
Xiaobo Ma ◽  
...  
Keyword(s):  
Middle Ear ◽  
Round Window ◽  
Oval Window ◽  
Active Middle Ear Implant ◽  
Middle Ear Implant

Optical coherence tomography of the oval window niche

2009 ◽  
Vol 123 (6) ◽  
pp. 603-608 ◽  
Author(s):  
T Just ◽  
E Lankenau ◽  
G Hüttmann ◽  
H W Pau
Keyword(s):  
Optical Coherence Tomography ◽  
Middle Ear ◽  
Imaging Modality ◽  
Oval Window ◽  
Annular Ligament ◽  
Middle Ear Surgery ◽  
Optical Coherence ◽  
Ear Surgery ◽  
Temporal Bones

AbstractObjective:Optical coherence tomography was used to study the stapes footplate, both in cadaveric temporal bones and during middle-ear surgery.Materials and methods:Optical coherence tomography was conducted on five temporal bone preparations (from two children and three adults) and in eight patients during middle-ear surgery. A specially equipped operating microscope with integrated spectral domain optical coherence tomography apparatus was used for standard middle-ear surgical procedures.Results:This optical coherence tomography investigation enabled in vivo visualisation and documentation of the annular ligament, the different layers of the footplate and the inner-ear structures, both in non-fixed and fixed stapes footplates. In cases of otosclerosis and tympanosclerosis, an inhomogeneous and irregularly thickened footplate was found, in contrast to the appearance of non-fixed footplates. In both fixed and non-fixed footplates, there was a lack of visualisation of the border between the footplate and the otic capsule.Conclusions:Investigation of the relatively new technology of optical coherence tomography indicated that this imaging modality may assist the ear surgeon to assess the oval window niche intra-operatively.

Influence of ossicular chain malformation on the performance of round-window stimulation: A finite element approach

2019 ◽  
Vol 233 (5) ◽  
pp. 584-594 ◽  
Author(s):  
Houguang Liu ◽  
Hu Zhang ◽  
Jianhua Yang ◽  
Xinsheng Huang ◽  
Wen Liu ◽  
...  
Keyword(s):  
Finite Element ◽  
Middle Ear ◽  
Basilar Membrane ◽  
Round Window ◽  
Low Frequency ◽  
Element Model ◽  
Ossicular Chain ◽  
Asymmetric Structure ◽  
Low Frequencies ◽  
Stapes Fixation

As a novel application of implantable middle ear hearing device, round-window stimulation is widely used to treat hearing loss with middle ear disease, such as ossicular chain malformation. To evaluate the influence of ossicular chain malformations on the efficiency of the round-window stimulation, a human ear finite element model, which incorporates cochlear asymmetric structure, was constructed. Five groups of comparison with experimental data confirmed the model’s validity. Based on this model, we investigated the influence of three categories of ossicular chain malformations, that is, incudostapedial disconnection, incus and malleus fixation, and fixation of the stapes. These malformations’ effects were evaluated by comparing the equivalent sound pressures derived from the basilar membrane displacement. Results show that the studied ossicular chain malformations mainly affected the round-window simulation’s performance at low frequencies. In contrast to the fixation of the ossicles, which mainly deteriorates round-window simulation’s low-frequency performance, incudostapedial disconnection increases this performance, especially in the absence of incus process and stapes superstructure. Among the studied ossicular chain malformations, the stapes fixation has a much more severe impact on the round-window stimulation’s efficiency. Thus, the influence of the patients’ ossicular chain malformations should be considered in the design of the round-window stimulation’s actuator. The low-frequency output of the round-window simulation’s actuator should be enhanced, especially for treating the patients with stapes fixation.

A new device for real-time peroperative monitoring of ossicular chain reconstruction during middle ear surgery

2019 ◽  
Vol 34 (4) ◽  
pp. 827-832
Author(s):  
Van Son Nguyen ◽  
Didier Rouxel ◽  
Brice Vincent ◽  
Joël Ducourneau ◽  
Cécile Parietti-Winkler
Keyword(s):  
Real Time ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
New Device ◽  
Ossicular Chain Reconstruction

Rupture of the round Window Membrane

1976 ◽  
Vol 85 (1) ◽  
pp. 105-110 ◽  
Author(s):  
P. H. Taylor ◽  
P. G. Bicknell
Keyword(s):  
Middle Ear ◽  
Surgical Intervention ◽  
Round Window ◽  
Oval Window ◽  
Round Window Membrane ◽  
Physical Effort ◽  
Cochlear Aqueduct ◽  
Definite Improvement ◽  
History Of ◽  
Pressure Changes

A case of sudden deafness due to rupture of the round window membrane is presented. Nineteen similar cases have previously been reported in the literature. In a review of these twenty patients, it is noted that a history of concurrent physical effort or barotrauma was present in eighteen. This supports the view that the injury is produced by pressure changes acting either along the cochlear aqueduct (the explosive route) or, directly on the middle ear structures (the implosive route). At operation, the rupture may be difficult to see, and a separate leak from the oval window may be present. The timing of any surgical intervention is important. The authors recommend that this should be deferred for one week after the onset of symptoms, as the fistula may heal spontaneously. If no definite improvement has occurred at the end of this time, then tympanotomy should be undertaken during the next week.

Unusual middle-ear mischief: trans-tympanic trauma from a hair grip resulting in ossicular, facial nerve and oval window disruption

2006 ◽  
Vol 120 (9) ◽  
pp. 793-795 ◽  
Author(s):  
J D Snelling ◽  
A Bennett ◽  
P Wilson ◽  
M Wickstead
Keyword(s):  
Facial Nerve ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Oval Window ◽  
Delayed Presentation ◽  
Stapes Footplate ◽  
Horizontal Portion

A case of piercing of the tympanic membrane, resulting in unusual consequences, is described. This is the first reported case of the long process of a dislocated incus resulting in trauma to the horizontal portion of a dehiscent facial nerve. Simultaneous depression of the stapes footplate resulted in a perilymph leak, but with delayed presentation.

The effects of fibrin tissue adhesive on the middle ear

1983 ◽  
Vol 97 (2) ◽  
pp. 141-148 ◽  
Author(s):  
D. Katzke ◽  
A. Pusalkar ◽  
E. Steinbach
Keyword(s):  
Inner Ear ◽  
Fibrin Glue ◽  
Middle Ear ◽  
Microscopic Examination ◽  
Oval Window ◽  
Tissue Adhesive ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Membranous Labyrinth ◽  
Fibrin Tissue Adhesive

AbstractThis study investigated the effects of fibrin glue (‘Tissucol’, Immuno Pty. Ltd.) in the middle and inner ear. Small amounts of the adhesive were used in 36 operations performed on 18 rabbits. The light microscopic examination of these ears four, eight and 12 weeks after surgery showed that the adhesive was well tolerated and that it did not have any toxic effecton on the middle ear or membranous labyrinth. The fibrin tissue adhesive can therefore safely be used to facilitate reconstructive middle-ear surgery and, with the aid of fasic, also for the closure of labyrinthine fistulae; or to achieve a definite seal of the oval window niche after stapes surgery.

Congenital Perilymphatic Fistula: Computed Tomography Appearance of Middle Ear and Inner Ear Anomalies

1994 ◽  
Vol 111 (3P1) ◽  
pp. 243-249 ◽  
Author(s):  
Jane L. Weissman ◽  
Peter C. Weber ◽  
Charles D. Bluestone
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Inner Ear ◽  
Middle Ear ◽  
Round Window ◽  
Clinical Suspicion ◽  
Perilymphatic Fistula ◽  
Computed Tomography Scans ◽  
Ear Anomalies ◽  
Tomography Appearance

Congenital perilymphatic fistula is an abnormal communication between the inner ear and middle ear. Inner ear anomalies have been described on computed tomography scans. Middle ear anomalies have been found at surgery; the most frequent are anomalies of the stapes and round window. This retrospective study describes the appearance of the inner and middle ear on computed tomography scans, and of the middle ear at surgery, in 10 patients (15 ears) in whom perilymphatic fistula was found at surgery. Twelve of 15 stapes were abnormal at surgery; 4 of these 12 (33%) could be seen on computed tomography scans. Two stapes normal at surgery were normal on computed tomography. Three round windows were abnormal at surgery; none of these was seen on computed tomography scans. There were also four dysplastic cochleas, four dysplastic vestibules, and three dilated vestibular aqueducts. Computed tomography scans identified an abnormal inner ear, middle ear, or both in 8 (53%) of the 15 ears with perilymphatic fistula. An inner ear or middle ear anomaly on computed tomography may heighten clinical suspicion of congenital perilymphatic fistula.

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