Kontorinis Georgios, Goetz Friedrich, Lenarz Thomas, Schwab Burkard
Department of Otorhinolaryngology, Hanover Medical University, Hanover, Germany.
ORL J Otorhinolaryngol Relat Spec. 2011;73(2):76-81. doi: 10.1159/000323439. Epub 2011 Jan 27.
Aim of this study was to examine any stapes fixation-related clinical, intraoperative and high-resolution computed tomography (HRCT) findings in children undergoing stapedotomy.
Detailed diagnostic assessment was performed in 12 children (18 ears) who underwent stapedotomy within the period 2005-2008.
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%).
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.
本研究旨在检查接受镫骨手术的儿童中任何与镫骨固定相关的临床、术中及高分辨率计算机断层扫描(HRCT)结果。
对2005年至2008年期间接受镫骨手术的12名儿童(18只耳)进行了详细的诊断评估。
临床和/或术中诊断出耳畸形,如锤骨-砧骨异常、锤骨-上鼓室固定和镫骨肌腱缺失、外耳道狭小和耳廓畸形。HRCT在4只耳中发现了岩部高位颈静脉球和内耳道畸形;然而,它未能识别听骨链固定。在2名儿童中发现了全身性异常,即脊柱侧凸、食管闭锁和手指畸形。总之,8名患者(66.7%)发现了额外的解剖学异常。
镫骨固定的儿童可能并存耳畸形。HRCT不易识别听骨链固定,因此术中应始终测试听骨链活动度。在少数情况下,小儿镫骨固定可与全身性发育异常并存;在此类患者中,建议额外转诊给遗传学家。