Clinical Characteristics And Intervention Effect Of Congenital Middle Ear Malformation

Objective:This study explores and analyzes the clinical features of simple congenital middle ear malformations and congenital outer middle ear malformations with cholesteatoma,such as imaging examination,Audiological performance,and surgical treatment methods and effects,in order to provide reference for clinical diagnosis and treatment.Materials and methods:1.12 ears with simple congenital middle ear malformations who underwent surgical treatment in our department were collected from July 2014 to June 2019.A combination of the three-dimensional volume reconstruction of the ossicular bone and the high-resolution computer tomography(HRCT)of the temporal bone was used to classify and score the congenital middle ear malformations.Based on the findings during the operation,we compared and analyzed the conformity and difference of the preoperative evaluation,and follow up the surgical intervention methods and treatment effects of the treated patients2.The clinical data of patients with congenital outer and middle ear malformations and cholesteatoma(5 cases)who underwent surgical treatment in our department from January 2017 to July 2018 and followed up for more than 2 years after the operation were collected,in order to review and summarize the diagnosis and treatment process,and propose its clinical features and diagnosis and treatment points.Results:1.The three-dimensional volume reconstruction technique can display more clearly than HRCT for the the microstructure of the middle ear such as the anvil and pedal joints;A combination of the three-dimensional volume reconstruction of the ossicular bone and the high-resolution computer tomography(HRCT)of the temporal bone can classify and score the congenital middle ear malformations more accurately;in this study,including type III 6 ears,type IV 3 ears,type II 2 ear,and type I 1 ear;further scoring of congenital middle ear malformations,Among them,2 ears for 9 points,5 ears for 8 points,3 ears for 7 points,1 ear for 5 points,1 ear for 4 points.According to the classification and scoring,and combined with specific conditions,different surgical treatments were performed for 12 ears of congenital middle ear malformations,and they were all successfully treated.Among them,9 ears were followed up for more than 1 year.2.5 cases of congenital malformation of the outer and middle ear with cholesteatoma had extensive lesions and severe hearing loss,and the preoperative average air conduction threshold of hearing was(64±9.3)d B.All 5 cases were treated with surgery,and followed up more than 2 years.Their postoperative hearing was improved(22.25±7.17)d B.there was no relapse or recurrence of cholesteatoma,and no complications such as restenosis of the external auditory canal.Conclusion:1.The three-dimensional volume reconstruction technique of ossicular is valuable in the diagnosis of congenital middle ear malformations,combinationed which with temporal bone HRCT can more accurately judge the type and severity of congenital middle ear malformations.Ossicular chain deformity,type III and 7-8 points are the most common for congenital middle ear malformations.The classification and scoring of middle ear malformations before surgery is beneficial to the correct selection of surgical options and good hearing improvement effects.2.The condition of patients with congenital malformation of the outer middle ear and cholesteatoma is complicated,and some cases require 2 or even more operations;accurate evaluation and the appropriate surgical protocol before the operation are the prerequisites for successful treatment;complete removal of the lesion and appropriate size of external auditory canal which was reconstructed were the key to the success of the operation;patients with congenital external and middle ear malformations with cholesteatoma often have more severe hearing loss,and one-stage hearing reconstruction can obtain hearing improvement.