72 cases of the auditory ossicle malformations but with normal findings in the tympanic membrane

Abstract

We evaluated 66 patients (72 ears) with auditory ossicle malformations, but with normal findings in the tympanic membrane, who underwent ossicular reconstruction and stapes surgery at our department between 1984 and 1997. There were 27 men (30 ears) and 39 women (42 ears). Classification of pathologic condition based on surgical findings showed separation of the incus-stapes joint in 43%, fixation of the malleus or incus in 16%, fixation of the stapes footplate in 26%, in incidence of fixation of the auditory oosicles that is higher than that previously reported. In 33% of the patients, conductive hearing loss or mixed hearing loss similar to that observed on the affected side was also present on the contralateral side. Abnormalities in the arrangement of the facial nerves were noted in 4%, inner ear malformation in 1%, and congenital cholesteatoma in 3%. Auditory ossicle reconstruction was performed by the modified type III method in 57% and by the modified type IV method in 37% of the cases. During stapes surgery, 86% underwent small-fenestra stapedectomy. Improvement in hearing after the operation was observed in 90% of the cases and the improvement was relatively high compared with tympanoplasty for chronic otitis media.