Learning Objectives:
Object: To study of simple congenital ossicular malformation clinical and audiological characteristics, and to discuss options to different auditory ossicles in ossicular chain reconstruction.
Methods: Ossicular chain malformations in 75 cases (79 ears) were studied involving 43 males and 32 females, aged from 6 to 57 years old (average 23.5±14.5 years old). There are four cases of bilateral conductive deafness and 71 cases of unilateral conductive deafness (39 left ears and 32 right ears). Results of preoperative audiometry showed that air-bone gap was 38.7 ;dB of speech frequency. We operated exploratory tympanotomy in 79 ears (4 cases of bilateral). Among them, ossicular chain reconstruction was performed in 71 cases, while in six cases not done because of facial deformity, and in two cases ossicle joints'activities were good after incudostapedial joint release.
Results: According to Teunissen classification (1993), we divided 79 ears into four groups, including 5 (6.3%, 5/79) ears of type I, 11(14%, 11/79) ears of type II , 47(59.5%, 47/79) ears of type III, 16(20.3%, 16/79) ears of type IV 0.5 cases of type I were implanted with Piston. 11 cases of type II were implanted with Piston, including Kurz(3), Spiggle(5), Xomed(3). For type III, 23 cases were implanted with partial ossicular replacement prosthesis (PORP), including Kurz(6), TTP(5), Xomed(12); 2 cases were implanted with autologous incus; 20 cases were implanted with total ossicular replacement prosthesis (TORP), including TTP(7), Spiggle(2), Xomed(10), autologous incus(1); and 2 cases were performed with incudostapedial joint release. 10 cases of type IV had done oval window drill-out occicular reconstruction, including 8 cases with Piston, 2 cases with TORP. The average air-bone gap was 21.5 dB in two weeks post-surgery.
Conclusion: Ossicular chain reconstruction with selection of different types of artificial ossicular is an effective method to improve hearing and decrease air-bone gap.
