多中心先天性中耳畸形研究。246 耳报告。

Multicenter Study of Congenital Middle Ear Anomalies. Report on 246 Ears.

机构信息

Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.

Department of Otolaryngology Head and Neck Surgery, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

Laryngoscope. 2021 Jul;131(7):E2323-E2328. doi: 10.1002/lary.29482. Epub 2021 Mar 1.

DOI:10.1002/lary.29482

PMID:33645732

Abstract

OBJECTIVES/HYPOTHESIS: Congenital middle ear anomalies represent a relatively rare condition. This study aimed to describe the characteristics and the surgical outcomes for patients with middle ear anomalies.

METHODS

A multicenter study was conducted of consecutive patients with congenital middle ear anomalies who underwent primary surgical treatment between January 2008 and December 2017. Demographics, surgical procedures, and audiometric data were registered into the institutional database. Hearing changes and postoperative air-bone gap (ABG) were evaluated 1 year after surgery.

RESULTS

A total of 246 patients (246 ears) (median age: 14 years, range: 4-75 years old) were included in this study. Anomalies were subdivided using the Teunissen and Cremers classification: 53 ears (22%) were categorized as class I, comprising only stapes ankylosis; 35 ears (14%) as class II, having ossicular chain anomalies with stapes ankylosis; 139 ears (57%) as class III, having ossicular chain anomalies with a mobile stapes-footplate; and 19 ears (8%) as class IV, with aplasia of the oval window. Evaluation of hearing outcomes for 198 ears with more than 1 year of follow-up revealed that good postoperative ABG (≤20 dB) was achieved in 82% of class I, 68% of class II, 74% of class III, and 23% of class IV anomalies. The postoperative ABG in class IV was significantly worse than in class I (P < .001) or class III (P < .01).

CONCLUSIONS

This study demonstrated that class III anomalies comprised the majority of middle ear anomalies and surgical outcomes for class IV anomalies are unfavorable.

LEVEL OF EVIDENCE

4 Laryngoscope, 131:E2323-E2328, 2021.

摘要

目的/假设：先天性中耳畸形是一种相对罕见的疾病。本研究旨在描述中耳畸形患者的特征和手术结果。

方法

对 2008 年 1 月至 2017 年 12 月期间接受原发性手术治疗的先天性中耳畸形连续患者进行了一项多中心研究。将人口统计学资料、手术过程和听力数据登记到机构数据库中。术后 1 年评估听力变化和术后气骨导差（ABG）。

结果

本研究共纳入 246 例（246 耳）（中位年龄：14 岁，范围：4-75 岁）患者。根据 Teunissen 和 Cremers 分类对畸形进行了细分：53 耳（22%）为 I 类，仅存在镫骨固定；35 耳（14%）为 II 类，存在听小骨链异常伴镫骨固定；139 耳（57%）为 III 类，存在听小骨链异常伴活动的镫骨足板；19 耳（8%）为 IV 类，卵圆窗发育不全。对 198 耳随访时间超过 1 年的听力结果进行评估，结果显示 I 类、II 类、III 类和 IV 类畸形的术后 ABG 分别有 82%、68%、74%和 23%良好。IV 类畸形的术后 ABG 明显差于 I 类（P<.001）或 III 类（P<.01）。