Evaluation of the Curative Effects of Surgical Intervention in Cases of Congenital Malformation of the Ossicular Chain in Children.

Junsong Zhen,Wei Liu,Ning Ma,Jianbo Shao,Xiaoxu Wang,Yuxin Liu,Shilan Li,Lining Guo,Jie Zhang
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Abstract

Purpose: Congenital malformation of the ossicular chain results in challenges with hearing and language development in children. We aimed to analyze the clinical characteristics, prognosis, and surgical treatments of different types of congenital ossicular chain malformations in children. Methods: Eight cases (10 ears) treated between October 2019 and February 2022 were analyzed retrospectively. Patients were divided according to the location of the ossicular chain malformation and whether it was complicated by external ear malformation. Imaging, audiological examination, intraoperative exploration of the middle ear, and postoperative outcomes were recorded. Results: Group 1 incudostapedial joint deformity): 6 ears/60%; Group 2 (simple incus deformity): 2 ears/20%; Group 3 (simple malleus deformity): 2 ears/20%; Group A (with external ear malformations): 4 ears/40%; Group B (without external ear malformations): 6 ears/60%. The average hearing threshold before and after the operation was 51.25 ± 12.88 and 31.94 ± 12.96 dB, respectively. There were differences in the intervention effects of different malformed sites (Group 1: t = 5.139, P = .004; Group 2: t = 13.500, P = .047; Group 3: t = 15.000, P = .042). The effect of the intervention in cases of malformation with mobile stapes footplates was better than that with immobile stapes footplates (t = 4.082, P = .027). The effect of the intervention without external ear malformations was better than that with external ear malformations (t = 7.706, P = .001). Conclusions: The intervention yielded superior results in cases of malformation with mobile stapes footplates compared to those with immobile stapes footplates. Different intervention strategies should be determined through precise deformity assessments, with the degree of stapes mobility serving as a crucial factor in improving the prognosis.
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评估手术干预对儿童先天性耳骨链畸形病例的疗效。
目的:先天性听骨链畸形给儿童的听力和语言发育带来挑战。我们旨在分析不同类型儿童先天性听骨链畸形的临床特征、预后和手术治疗方法。方法:回顾性分析2019年10月至2022年2月期间接受治疗的8例患者(10耳)。根据听骨链畸形的位置和是否并发外耳畸形对患者进行分类。记录了影像学、听力学检查、术中中耳探查和术后结果。结果第 1 组:内镫关节畸形(incudostapedial joint deformity):6耳/60%;第2组(单纯切迹畸形)2耳/20%;A组(外耳畸形):4耳/40%;B组(无外耳畸形):6耳/60%:6耳/60%。手术前后的平均听阈分别为 51.25 ± 12.88 和 31.94 ± 12.96 dB。不同畸形部位的干预效果存在差异(第一组:t = 5.139,P = .004;第二组:t = 13.500,P = .047;第三组:t = 15.000,P = .042)。对有活动镫骨足板的畸形病例的干预效果优于无活动镫骨足板的病例(t = 4.082,P = .027)。无外耳畸形者的干预效果优于有外耳畸形者(t = 7.706,P = .001)。结论:对有活动镫骨足板的畸形病例进行干预的效果优于有不动镫骨足板的病例。应通过精确的畸形评估来确定不同的干预策略,其中镫骨活动度是改善预后的关键因素。
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