Classification of Congenital Middle Ear Anomalies Report on 144 Ears

Teunissen, Erik; Cremers, W. R. J.

doi:10.1177/000348949310200807

Cited by 130 publications

(146 citation statements)

References 14 publications

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“…The anomalies identified among the 78 cases were described based on 21 different types and included ( Figure 1): (1) no incus long process (5 cases), (2) no incus long process with a fibrous band (3 cases), (3) fused malleus and incus (2 cases), (4) an incus fused to the medial attic wall (1 case), (5) a malleus fused to the anterior attic wall (1 case), (6) a stapes without an anterior crus (3 cases), (7) no anterior crus and no incus long process (3 cases), (8) no anterior crus and no incus long process with a fibrous band (1 case), (9) no stapes suprastructure and no incus long process (6 cases), (10) a stapes footplate fixation only (36 cases), (11) stapes footplate fixation without an anterior crus (4 cases), (12) stapes footplate fixation without an anterior crus and incus long process (2 cases), (13) stapes footplate fixation with obturator foramen obliteration (1 case), (14) stapes footplate fixation without a lenticular process, only a fibrous band (1 case), (15) stapes footplate fixation without a stapes head (1 case), (16) stapes footplate fixation with a monopolar crus and no incus long process (1 case), (17) underdeveloped stapes crura without an oval window (2 cases), (18) anterior and posterior crura fusion without an oval window (1 case), (19) no stapes and no oval window (2 cases), (20) no stapes and no oval window without an incus long process (1 case), (21) no stapes and no oval window with an incus long process fused to the promontrium (1 case).…”

Section: Resultsmentioning

confidence: 99%

“…After this, Arslan and Giacomelli [14] classified ossicular anomalies into five types, Ombredann [15] into three types, House [16] into five types, and Funasaka [8] into three types. In 1993, Teunissen and Cremers [4] analyzed their surgical findings in 144 ears with congenital conductive hearing loss, and reported a classification system to describe their findings, as follows. Class 1 includes ears with congenital isolated stapes ankylosis; class 2, ears with congenital stapes ankylosis in combination with a congenital anomaly of the ossicular chain; class 3, ears with congenital anomalies of the ossicular chain and at least a mobile stapes footplate; class 4, ears with aplasia or severe dysplasia of the oval window or round window.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical findings were compared with the preoperative temporal bone CT results. The anomalous ossicles were also classified into five types according to the status of the stapes footplate (Table I), according to a modification of the Teunissen and Cremers classification system (1993) [4].…”

Section: Methodsmentioning

confidence: 99%

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Isolated congenital ossicular anomalies

Park

Choung

2009

Acta Oto-Laryngologica

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Conclusions. Isolated congenital ossicular anomalies are diverse. Our proposed modified Teunissen and Cremers classification will be helpful for the evaluation of congenital ossicular anomalies as well as the prediction of surgical outcome. Objectives. The aim of this study was to describe isolated congenital ossicular anomalies encountered in patients who have normal eardrums and to evaluate their surgical outcome based on their classification. Patients and methods. A total of 78 patients (94 ears) with congenital ossicular anomalies were reviewed. The preoperative and postoperative audiological findings, surgical findings, and temporal bone CT results were analyzed. Results. Twenty-one types of ossicular anomalies were identified in this study. A stapes footplate fixation was the most common anomaly and this was usually bilateral. However, the anomalies that were associated with the incus and malleus were usually unilateral. The congenital ossicular anomalies were classified into five types according to the status of the stapes footplate. Using this modification of a prior classification system, the more severe anomalies of the stapes footplate could be identified, and the worst postoperative hearing result could be predicted.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Isolated congenital ossicular anomalies

Park

Choung

2009

Acta Oto-Laryngologica

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“…The most common anomaly in this area consists of aplasia of the long process of the incus and the head of the stapes [14][15][16][17]. Absence of the incus long process bone and stapedial crura (as in cases 4, 5, 7, 9) was easily recognized with both VE image and SSD.…”

Section: Discussionmentioning

confidence: 99%

“…It is also possible for a conductive hearing loss to result from fibrous atrophy of the long process of the incus in which the periosteum remains intact but there is no real bony continuity [14,17]. This condition of incudal pseudocontinuity produced by the intact periosteum creates a surgical and radiological diagnostic trap [18].…”

Section: Discussionmentioning

confidence: 99%

Middle Ear Imaging Using Virtual Endoscopy and Its Application in Patients with Ossicular Chain Anomaly

Himi¹,

Sakata

Shintani³

et al. 2000

ORL

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Virtual endoscopy (VE) is a recently developed technique to provide a realistic surface rendering of various organs, which can be applied to the use of three-dimensional (3D) studies of several lesions. However, its advantages in otological disease have not been well investigated. In this study, we evaluated the application of VE in patients with ossicular chain anomalies. Virtual middle ear endoscopy was a time-saving method, however, we needed the appropriate technical procedures of algorithm and reconstruction spacing to generate accurate 3D images of ossicles. We obtained virtual surgical views of middle ear structures and related anomalies, and confirmed by intraoperative findings that these images were mostly compatible with the actual lesions of ossicles. VE allowed an identification of the anatomy of the ossicles and adjacent structures simultaneously. The elements of the stapedial crura were clearly visualized with VE images in 93.3% of normal ears. Pathological ossicular chain findings such as malleus or incus fixation, dislocation and disruption, except footplate fixation were investigated successfully. One possible procedure, using alterable CT value in the obtained VE images on the monitor, is proposed for further detection of fine lesions of the ossicles. These observations suggest that virtual middle ear simulations accurately represent major intraoperative findings. This technique may have an important role in preoperative planning, surgical training, and/or postoperative evaluation in otology.

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Congenital Stapes Ankylosis Associated With Another Ossicular Chain Anomaly<subtitle>Surgical Results in 30 Ears</subtitle>

Thomeer¹,

Kunst²,

Cremers³

2011

Arch Otolaryngol Head Neck Surg

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Surgery for congenital stapes footplate ankylosis with a concomitant ossicular chain anomaly can provide worthwhile hearing improvement. The ABG closure was 20 dB or less in 21 of 30 ears (70%). Most ears had some sensorineural impairment (10-20 dB), which influenced the final hearing level after surgery. Over recent decades, the technique of the malleostapedotomy procedure has been improved. Preoperative assessment is mandatory for syndromal diagnoses, which might be important for patient counseling and prognosis.

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Classification of Congenital Middle Ear Anomalies Report on 144 Ears

Cited by 130 publications

References 14 publications

Isolated congenital ossicular anomalies

Isolated congenital ossicular anomalies

Middle Ear Imaging Using Virtual Endoscopy and Its Application in Patients with Ossicular Chain Anomaly

Congenital Stapes Ankylosis Associated With Another Ossicular Chain Anomaly<subtitle>Surgical Results in 30 Ears</subtitle>

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