Endoscopic Ear Surgery in Congenital Middle Ear Malformation by Double Handed Technique

By June 7, 2019

Zhang, Chi1,2; Wu, Peina1; Fu, Min1; Ge, Runmei1; Huang, Hongming1; Cui, Yong1
1 Department of Otorhinolaryngology, Guangdong Provincial People’s Hospital, No.106, Zhong Shan Er Lu, Guangzhou, China;
2 Shantou University of Medical School, No.22 Xinling Road, Shantou, China.

Congenital middle ear malformations are rare and varied anatomy abnormalities of ossicular chain leads to a surgical challenge for otologists. Endoscopic ear surgery might be indicated for management of congenital middle ear malformation due to the widen view of middle ear structures. The aim of this work was to report the feasibility and our experience of endoscopic surgical treatment by doube-handed techinque of congenital middle ear malformations.

Study design retrospective case review
-Setting tertiary referral center
-Patients 16 patients with congenital middle ear malformation who underwent endoscopic ear surgery from July 2017 to January 2019 were enrolled into study.
-Intervention Endoscopic ossiculoplasties were performed in 15 patients.

-Results Patients were classified into 5 types according to Park & Choung‘s classification: type 1 (4 cases, 25.00%), type 2 (5 cases, 31.25%), type 3 (1 case, 6.25%), type 4 (5 cases, 31.25%) and type 5 (1 case, 6.25%). 4 cases were reconstructed by PORP; 5 cases by TORP and 6 cases by piston; 1 case did not undergo ossiculoplasty due to facial nerve aberration blocking the oval window. Facial nerve was found abnormal in 3 cases (18.75%). 6 cases were lost follow-up. The air-bone gap (ABG) in the rest of 10 cases before surgery were 39.75dBHL and after surgery were 16dBHL. ABG in 10 cases decreased over 10 dBHL.

Double handed technique is helpful in the complicated procedures in the endoscopic ear surgery of congenital middle ear malformation.