1
|
Liu Y, Wang H, Zhao D, Zhu Y, Wang F, Jia J, Wang J, Hou Z. [The application of endoscope and microscope in the stapes surgeries]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 38:108-111. [PMID: 38297862 DOI: 10.13201/j.issn.2096-7993.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Indexed: 02/02/2024]
Abstract
Objective:To compare the application of endoscope and microscope in all kinds of stapes surgeries. Methods:Fifty-nine stapes surgeries have been collected from April 2020 to May 2023 in Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School. Hearing level, hospital stay post-operation, times of hospital visit post-operation, etc. have been compared between the endoscopic group and microscopic group. Patients who were failed to place the stapes prosthesis because of the poor exposure of the oval window have been analyzed. Results:Otosclerosis was the most common diagnosis in both groups. There was 1(1/23) middle ear malformation in the endoscopic group and 5(5/36) middle ear malformations in the microscopic group. There were 2 Van Der Hover syndromes and 4 Treacher Collins syndromes in the microscopic group. In the endoscopic group ABG of 10 ears(43.5%) ≤ 10 dB, and ABG of 21 ears(91.3%) ≤20 dB.In the microscopic group ABG of 13 ears(41.9%) ≤ 10 dB, and ABG of 28 ears(90.3%) ≤ 20 dB. There was no statistic difference between 2 groups. Times of hospital visit post-operation in the endoscopic group was less than in the microscopic group(P<0.01). There was no facial palsy, tympanic perforation or profound sensorineural hearing loss in both groups. Conclusion:Endoscope is more suitable for patients who are evaluated with no severe stapes malformation, or less manipulation of drilling the bone. It could also reduce the hospital visit post-operation. Patients with narrow ear canal or severe middle ear malformation are recommended to perform the surgery with microscope, because it provides the chance of manipulation with 2-hands of surgeons.
Collapse
Affiliation(s)
- Ya Liu
- Senior Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Chinese PLA Medical School;State Key Laboratory of Hearing and Balance Science;National Clinical Research Center for Otolaryngologic Diseases;Key Laboratory of Hearing Science,Ministry of Education;Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Beijing,100037,China
| | - Huibing Wang
- Senior Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Chinese PLA Medical School;State Key Laboratory of Hearing and Balance Science;National Clinical Research Center for Otolaryngologic Diseases;Key Laboratory of Hearing Science,Ministry of Education;Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Beijing,100037,China
| | - Danheng Zhao
- Senior Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Chinese PLA Medical School;State Key Laboratory of Hearing and Balance Science;National Clinical Research Center for Otolaryngologic Diseases;Key Laboratory of Hearing Science,Ministry of Education;Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Beijing,100037,China
| | - Yuhua Zhu
- Senior Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Chinese PLA Medical School;State Key Laboratory of Hearing and Balance Science;National Clinical Research Center for Otolaryngologic Diseases;Key Laboratory of Hearing Science,Ministry of Education;Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Beijing,100037,China
| | - Fangyuan Wang
- Senior Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Chinese PLA Medical School;State Key Laboratory of Hearing and Balance Science;National Clinical Research Center for Otolaryngologic Diseases;Key Laboratory of Hearing Science,Ministry of Education;Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Beijing,100037,China
| | - Jianping Jia
- Senior Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Chinese PLA Medical School;State Key Laboratory of Hearing and Balance Science;National Clinical Research Center for Otolaryngologic Diseases;Key Laboratory of Hearing Science,Ministry of Education;Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Beijing,100037,China
| | - Jin Wang
- Senior Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Chinese PLA Medical School;State Key Laboratory of Hearing and Balance Science;National Clinical Research Center for Otolaryngologic Diseases;Key Laboratory of Hearing Science,Ministry of Education;Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Beijing,100037,China
| | - Zhaohui Hou
- Senior Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Chinese PLA Medical School;State Key Laboratory of Hearing and Balance Science;National Clinical Research Center for Otolaryngologic Diseases;Key Laboratory of Hearing Science,Ministry of Education;Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Beijing,100037,China
| |
Collapse
|
2
|
Zhang M, Lin J, Zhang J, Han Z, Liu C, Zou Y. A clinical epidemiological study on congenital ear malformation (CEM). Acta Otolaryngol 2023; 143:S17-S24. [PMID: 38071650 DOI: 10.1080/00016489.2023.2276348] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/11/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND There is no report about the definition, classification and clinical epidemiological study of congenital ear malformation (CEM).Aims/Objectives: To investigate the definition, clinical classification and distribution of a large number of CEM cases, along with the clinical and epidemiological characteristics associated with congenital malformation of the middle and outer ear (CMMOE). MATERIAL AND METHODS A total of 3231 cases (4714 ears) with CEM and related malformations were retrospectively analyzed, including 2,658 cases (4,064 ears) CEM and 573 cases (650 ears) preauricular fistulas and accessory ears, specifically related malformations to CEM. RESULTS Among the 2,658 cases (4,064 ears) CEM, 64.9% cases were male and 35.1% were female. 52.9% cases with bilateral, 29.1% with right and 18.0% with left CEM. A subgroup of 1,050 cases (1,331 ears) was identified as CMMOE out of 1,090 cases (1,379 ears) microtia. In the CMMOE subgroup, 74.0% cases were male, 46.3% on the right side, 26.8% showed bilateral involvement. Out of the CMMOE with available images, there were 947 cases (1,105 ears). Additionally, related malformations including preauricular fistulas and accessory ears, were solely occured in 573 cases (650 ears), except for their occurrence simultaneously with CEM. The classification and distribution of CEM are as follows:1. 2658 cases of CEM (1) 69.9% of them were confined to the ear, including: ① the outer ear 2.6%, the middle ear 17.0% and the inner ear 32.4%, ② two parts simultaneous malformations of the outer ear, the middle ear and the inner ear 17.2%, ③ three parts simultaneous malformations of the outer ear, the middle ear and the inner ear 0.6%, (2) Multiple malformations including in CEM 29.1%; (3) syndromes related to CEM 1.0%.2. 1050 cases of CMMOE (1) 36.3% of them were confined to the middle and outer ears; (2) Multiple malformations associated with CMMOE 61.4%, including hemifacial microsomia 50.5%, accessory ears 9.8%, preauricular fistulas 9.2%, heart malformation 7.1%, and kidney malformation 2.0%; and (3) syndromes related to CMMOE 2.3%, (4) Complications of the ear 16.9%, mainly including otitis media 7.9%, outer ear canal cholesteatoma 6.3%, retroauricular abscess 1.1%, and nasal and pharyngeal complications 18.6%. The proportions of microcia grades I-Ⅴ based on the images of 1105 ears CMMOE were 5.2%, 10.5%, 74.1%, 6.9%, and 3.3%, respectively. Among the 1331 ears CMMOE, the incidence rates of outer ear canal atresia, stenosis, normal, and ossicles malformation were 86.5%, 9.9%, 3.6%, and 98.3%, respectively.Conclusion and Significance: Approximately 69.9% of CEM cases were confined to the ear itself, with the highest proportion being inner ear malformation alone. Multiple malformations were predominantly associated with CMMOE. Syndromes related to CEM were relatively rare. Among cases of microtia, 96.3% were classified as CMMOE. These cases were predominantly observed in males, right ear and exhibited characteristics such as grade III microtia, atresia of the outer ear canal, ossicles malformation, and multiple malformations. The multiple malformations frequently included hemifacial microsomia, accessory ear, preauricular fistula, as well as heart and kidney deformities. CMMOE often coexisted with ear infections, cholesteatoma, and complications in the nasal and pharyngeal regions.
Collapse
Affiliation(s)
- Ming Zhang
- Senior Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Laboratory of Hearing and Balance Science, Beijing, China
| | - JiaHua Lin
- Senior Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Laboratory of Hearing and Balance Science, Beijing, China
| | - JingDa Zhang
- Health Medical Department, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, PLA General Hospital, Beijing, China
| | - ZeLi Han
- Senior Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Laboratory of Hearing and Balance Science, Beijing, China
| | - Chang Liu
- Senior Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Laboratory of Hearing and Balance Science, Beijing, China
| | - YiHui Zou
- Senior Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Laboratory of Hearing and Balance Science, Beijing, China
| |
Collapse
|
3
|
Abstract
BACKGROUND At present, there are not international unified standards and reports on Congenital Ear Malformation (CEM) in the world, which makes it difficult to transfer information and compare the literature. AIMS/OBJECTIVES Through the statistical analysis of a large sample of CEM, a unified standard of all aspects of CEM is proposed and the data are provided for reference, which is convenient for the international work and literature comparison in this field. MATERIALS AND METHODS Based on the author's 30 years of clinical and scientific research work on CEM and the relevant cases of 3231 (4714 ears) in our hospital, and combined with literature, statistical analysis was made. RESULTS This paper summarizes the classification, definition, epidemiology, embryonic development, pathogenic factors of CEM and elaborates on the clinical manifestations, examination and sequence therapy of representative Congenital Malformation of the Middle and Outer Ear (CMMOE). We also introduce malformation of the auricle and inner ear, so as to cover the outer, middle and inner ear. At the same time, we introduce our achievements and contributions in this field. CONCLUSIONS AND SIGNIFICANCE This study provides reference to the international unified standard and treatment principle of the CEM.
Collapse
Affiliation(s)
- YiHui Zou
- Senior Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China; National Clinical Research Center for Otolaryngologic Diseases, Beijing, China; State Key Laboratory of Hearing and Balance Science, Beijing, China
| |
Collapse
|
4
|
Gheorghe DC, Epure V, Oprea D, Zamfir-Chiru-Anton A. Persistent Stapedial Artery, Oval Window Atresia and Congenital Stapes Agenesis—Case Report. Medicina (B Aires) 2023; 59:medicina59030461. [PMID: 36984462 PMCID: PMC10059694 DOI: 10.3390/medicina59030461] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/20/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Background: The persistent stapedial artery (PSA) is a rare congenital vascular malformation involving the middle ear. It is usually associated with pulsatile tinnitus and/or conductive hearing loss and can account for multiple risks during middle ear surgery. Case Report: we present a case of a 9-year-old male child with conductive hearing loss and persistent stapedial artery in his right ear, who was admitted to our ENT Department for hearing loss. During surgery, we discovered PSA along with congenital stapes agenesis and oval window atresia, as well as an abnormal trajectory of the mastoid segment of the facial nerve. After ossicular reconstruction (transcanal total ossicular replacement prosthesis) with cochleostomy, no surgical complications were recorded and hearing improvement was monitored by pre- and postoperative audiometry. Conclusion: Stapedial artery is a rare anatomical middle ear abnormality that can prevent proper surgical hearing restoration and can be associated with other simultaneous temporal bone malformations.
Collapse
Affiliation(s)
- Dan Cristian Gheorghe
- ENT Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
- ENT Department, MS Curie Hospital, 077120 Bucharest, Romania
| | - Veronica Epure
- ENT Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
- ENT Department, MS Curie Hospital, 077120 Bucharest, Romania
- Correspondence: ; Tel.: +40-214-604-260
| | - Doru Oprea
- ENT Department, MS Curie Hospital, 077120 Bucharest, Romania
| | | |
Collapse
|
5
|
Elias TGA, Santos F. Developmental Disruptions of the Human Stapes. Otol Neurotol 2022; 43:e461-e466. [PMID: 35120079 PMCID: PMC8982995 DOI: 10.1097/mao.0000000000003490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate and classify developmental malformations of the human stapes. METHODS Twenty-five temporal bone specimens from 18 patients with congenital stapes malformations were identified in the Mass Eye and Ear temporal bone collection. Serial sections stained with hematoxylin and eosin were examined by light microscopy and the morphology of the stapes was compared to age-matched controls. RESULTS Each case of stapes malformation could be classified into one of four malformation types based on our current understanding of the embryologic origin of the subunits of the stapes and timing of development. Twenty-seven percent of stapes malformations had a Type I morphology characterized by a hypoplastic or absent inner footplate and hypoplastic to absent mesoderm footplate or oval window. The crura and capitulum may be absent, monopodal or dysmorphic. Eleven percent expressed a Type II malformation with dysmorphic or monopodal capitulum and crura and a fixed footplate. Twenty-seven percent were of Type III with a dysmorphic or monopodal capitulum and or crura. The footplate, and thereby oval window is present and without fixation. The most common malformation, Type IV, was isolated footplate fixation observed in 33% of cases. CONCLUSIONS Malformations of the human stapes follow consistent patterns of early or late disruptions of the stapes subunits of mesodermal and/or neural crest origin. While the molecular events, including temporal coordination, that lead to a normally formed stapes are not yet fully understood, the observed patterns of human stapes malformation can be consistently classified into one of four patterns of developmental disruption.
Collapse
Affiliation(s)
- Thaís Gomes Abrahão Elias
- Department of Otolaryngology, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, SP, Brazil
| | - Felipe Santos
- Department of Otolaryngology Mass Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
6
|
Nuñez-Castruita A, López-Serna N. Prenatal development of the human tympanic ring: a morphometric study with clinical correlations. Surg Radiol Anat 2021; 43:1187-1194. [PMID: 33398517 DOI: 10.1007/s00276-020-02654-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 12/10/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To establish normal reference values for the human Tympanic Ring (TR) during prenatal development, and to describe and interpret its growth dynamics. METHODS Fifty spontaneously aborted human fetuses aged 12-37 weeks with normal external characteristics were evaluated. The parameters measured in the TR were the cephalocaudal and dorsoventral axes, total area, thickness, height, and length and angle of the notch of Rivinus (NR). Data were subjected to statistical analysis. RESULTS The following values were obtained at the end of fetal development: cephalocaudal and dorsoventral axes, 10.03 and 8.3 mm, respectively; ratio between the two axes, 120%; total area, 65.63 mm2; height and thickness, 0.88 mm and 1.10 mm, respectively; and length and angle of the NR, 4.66 mm and 26.2 degrees, respectively. There were variations in the length of the dorsoventral axis throughout fetal development that affected all other parameters, except for the cephalocaudal axis. There were no sex-based differences in TR size. CONCLUSION The prenatal development of the TR is dynamic as evidenced by the size variations noted throughout fetal development. Notwithstanding, this structure is a reliable and sensitive marker of developmental abnormalities of the external and middle ear.
Collapse
Affiliation(s)
- Alfredo Nuñez-Castruita
- Department of Embryology, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Av. Francisco I. Madero y Dr. Eduardo Aguirre Pequeño S/N, Col. Mitras Centro., C.P. 64460, Monterrey, NL, México.
| | - Norberto López-Serna
- Department of Embryology, Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Av. Francisco I. Madero y Dr. Eduardo Aguirre Pequeño S/N, Col. Mitras Centro., C.P. 64460, Monterrey, NL, México
| |
Collapse
|
7
|
Serrano MDLA, Demarest BL, Tone-Pah-Hote T, Tristani-Firouzi M, Yost HJ. Inhibition of Notch signaling rescues cardiovascular development in Kabuki Syndrome. PLoS Biol 2019; 17:e3000087. [PMID: 31479440 PMCID: PMC6743796 DOI: 10.1371/journal.pbio.3000087] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 09/13/2019] [Accepted: 08/08/2019] [Indexed: 01/05/2023] Open
Abstract
Kabuki Syndrome patients have a spectrum of congenital disorders, including congenital heart defects, the primary determinant of mortality. Seventy percent of Kabuki Syndrome patients have mutations in the histone methyl-transferase KMT2D. However, the underlying mechanisms that drive these congenital disorders are unknown. Here, we generated and characterized zebrafish kmt2d null mutants that recapitulate the cardinal phenotypic features of Kabuki Syndrome, including microcephaly, palate defects, abnormal ear development, and cardiac defects. The cardiac phenotype consists of a previously unknown vasculogenesis defect that affects endocardium patterning and, consequently, heart ventricle lumen formation. Additionally, zebrafish kmt2d null mutants have angiogenesis defects depicted by abnormal aortic arch development, hyperactive ectopic blood vessel sprouting, and aberrant patterning of the brain vascular plexus. We demonstrate that zebrafish kmt2d null mutants have robust Notch signaling hyperactivation in endocardial and endothelial cells, including increased protein levels of the Notch transcription factor Rbpj. Our zebrafish Kabuki Syndrome model reveals a regulatory link between the Notch pathway and Kmt2d during endothelium and endocardium patterning and shows that pharmacological inhibition of Notch signaling rebalances Rbpj protein levels and rescues the cardiovascular phenotype by enhancing endothelial and endocardial cell proliferation and stabilizing endocardial patterning. Taken together, these findings demonstrate that Kmt2d regulates vasculogenesis and angiogenesis, provide evidence for interactions between Kmt2d and Notch signaling in Kabuki Syndrome, and suggest future directions for clinical research.
Collapse
Affiliation(s)
- Maria de los Angeles Serrano
- Molecular Medicine Program—Neurobiology and Anatomy Department, University of Utah, Salt Lake City, Utah, United States of America
| | - Bradley L. Demarest
- Molecular Medicine Program—Neurobiology and Anatomy Department, University of Utah, Salt Lake City, Utah, United States of America
| | | | - Martin Tristani-Firouzi
- Nora Eccles Harrison Cardiovascular Research and Training Institute and Division of Pediatric Cardiology, University of Utah, Salt Lake City, Utah, United States of America
| | - H. Joseph Yost
- Molecular Medicine Program—Neurobiology and Anatomy Department, University of Utah, Salt Lake City, Utah, United States of America
| |
Collapse
|
8
|
Monsanto RDC, Sennaroglu L, Uchiyama M, Sancak IG, Paparella MM, Cureoglu S. Histopathology of Inner Ear Malformations: Potential Pitfalls for Cochlear Implantation. Otol Neurotol 2019; 40:e839-e846. [PMID: 31361687 PMCID: PMC7377297 DOI: 10.1097/mao.0000000000002356] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
HYPOTHESIS The presence of bony inner ear malformations may associate with a number of anatomical abnormalities affecting the middle ear structures. Those malformations may create pitfalls and complications for cochlear implantation. BACKGROUND Inner ear malformations associate with varying degrees of hearing loss, and frequently require cochlear implantation for hearing rehabilitation. Therefore, the abnormalities affecting the middle- and inner-ear structures may increase the risk of surgical complications. METHODS We examined 38 human temporal bones from donors with bony inner ear malformations. Using light microscopy, we analyzed the presence of abnormalities in the structures of the middle- and inner-ear. RESULTS Our collection comprises of 38 specimens with inner-ear malformations (cochlear aplasia, n = 3; cochlear hypoplasia, n = 30; incomplete partition, n = 3; isolated vestibular malformation, n = 2). The anatomy of the middle ear was abnormal in most temporal bones with cochlear aplasia, cochlear hypoplasia, and incomplete partition type I (40%-100%). Some of those abnormalities (hypoplastic or obliterated mastoid, 55.2%; aplastic or obliterated round window, 71.0%; aberrant course of the facial nerve, 36.8%) may hinder the access to the round window using the conventional facial recess approach for cochlear implantation. The cochlear nerve and associated bony structures (internal auditory canal and bony canal for cochlear nerve) were normal in 71.0% of all temporal bones with inner ear malformations. CONCLUSION Each different type of malformation may create specific surgical challenges to surgeons. Comprehensive preoperative imaging is fundamental toward the surgical success of cochlear implants in patients with malformations. Alternatives to circumvent those middle- and inner-ear abnormalities and potential complications are further discussed.
Collapse
Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM) - São Paulo, SP, Brazil
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota - Minneapolis, Minnesota, USA
| | - Levent Sennaroglu
- Department of Otolaryngology, Head and Neck Surgery, Hacettepe University, Ankara, Turkey
| | - Mio Uchiyama
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota - Minneapolis, Minnesota, USA
- Department of Otolaryngology, Showa University, Tokyo, Japan
| | - Irem Gul Sancak
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota - Minneapolis, Minnesota, USA
- Department of Surgery, Ankara University Faculty of Veterinary Medicine, Ankara, Turkey
| | - Michael Mauro Paparella
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota - Minneapolis, Minnesota, USA
- Paparella Ear Head and Neck Institute - Minneapolis, Minnesota, USA
| | - Sebahattin Cureoglu
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota - Minneapolis, Minnesota, USA
| |
Collapse
|
9
|
Abstract
Microtia and atresia cause significant conductive hearing loss of up to 60 dB HL. The bilateral cases suffer from severely restricted communication abilities and require immediate acoustic stimulation. There is also growing evidence that unilateral cases benefit from an early and selective stimulation of the affected side. Hearing restoration can be performed in selected cases of minor malformation by classic middle ear reconstruction. However, the majority of patients presumably benefit better from a hearing aid. There are 3 main types: active middle ear implants, active bone conduction implants and passive bone conduction implants. All implants improve speech perception, speech recognition, the signal-to-noise ratio and directional hearing. The extent varies among implants and requires further studies. Decision making on the implant type depends on the extent of malformation and hence the preoperative imaging. New scoring systems provide reliable risk stratification. Second it depends on the age of the patient. The active middle ear implants provide a selective stimulation of the affected side and are beneficial if implanted in the first years of life during the maturation period of the auditory system. In conclusion, hearing rehabilitation of congenital atresia should be performed as early as possible. This includes not only the bilateral but also the unilateral affected patients.
Collapse
|
10
|
|
11
|
Affiliation(s)
- Robert Roger Lebel
- Departments of Pediatrics, Internal Medicine, Obstetrics/Gynecology, Pathology and Bioethics & the Humanities SUNY Upstate Medical University Syracuse, New York
| |
Collapse
|
12
|
Xu XJ, Hu Z, Ma HA, Yan DN, Xu YD, Zheng YQ. [The facial nerve study of multi-slice spiral computed tomography in congenital abnormality of external and middle ear]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:347-351. [PMID: 29871259 DOI: 10.13201/j.issn.1001-1781.2017.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Indexed: 06/08/2023]
Abstract
Objective:Images of temporal bone are obtained on Siemens 64 slices spiral CT scanner with high resolution scanning to describe the course of facial nerve for better preoperative evaluation of CAEMA.Method:To describe the course of facial nerve on rectangular coordinate system from three silce on HRCT, 29 patients(35 ears) are enrolled in our study in ENT department from November 2005 to March 2007 in the second affiliated hospital of sun yan sen university, who are all diagnosed not acquired deformity but CAEME, associated with no congenital deformity syndromes and no middle ear or mastoid operations before. Patients with bilateral ears deformity are 6, and unilateral ears deformity are 23 (13 right and 10 left) in the study group. The control group is the normal ears of unilateral ear deformity.Result:In the study group, the shortest distance from FN tympanic segment to oval window is shorter than that of the normal group (P< 0.05). In CAEME of unilateral ears the FN mastoid segment displaces anteriorly about 2.7 mm, and in CAEME of bilateral ears displaces 3.0mm, compared with the normal ears (P< 0.05). The deformity degree of auricle has correlations with anteriorly displacement of facial nerve mastoid segment (P< 0.05).Conclusion:The FN mastoid segment is anteriorly displacement in both bilateral and unilateral ear deformity. The deformity degree of auricle has correlations with anteriorly displacement of facial nerve mastoid segment. The lateral displacement of facial nerve doesn't occur usually in CAEME. The shortest distance between oval window and tympanic segment of FN become shorter than normal ears.
Collapse
Affiliation(s)
- X J Xu
- Department of Otorhinolaryngology, Chinese Medicine Hospital of Jiangsu Province, Nanjing, 210029, China
| | - Z Hu
- Department of Otorhinolaryngology, Chinese Medicine Hospital of Jiangsu Province, Nanjing, 210029, China
| | - H A Ma
- Department of Otorhinolaryngology, Chinese Medicine Hospital of Jiangsu Province, Nanjing, 210029, China
| | - D N Yan
- Department of Otorhinolaryngology, Chinese Medicine Hospital of Jiangsu Province, Nanjing, 210029, China
| | - Y D Xu
- Department of Otorhinolaryngology, the Second Hospital of Sun Yat-Sen University
| | - Y Q Zheng
- Department of Otorhinolaryngology, the Second Hospital of Sun Yat-Sen University
| |
Collapse
|
13
|
Abstract
Objectives: We describe a series of otologic complications from impression material used to make hearing aid molds. Methods: We examined a retrospective case series of patients presenting to a tertiary care academic medical center. Results: The presentation, clinical course, and treatment outcomes of 6 patients with complications related to ear molds are discussed. These patients had preexisting abnormalities in their aural anatomy, including tympanic membrane perforations, retraction pockets, and mastoidectomy cavities. Conclusions: Although the majority of patients who have ear canal impressions taken experience no adverse outcomes, hearing aid dispensers should perform a thorough history-taking and physical examination to discern those with abnormal anatomy at risk for complications. These patients may benefit from evaluation in conjunction with an otolaryngologist.
Collapse
Affiliation(s)
- Abraham Jacob
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio 43210, USA
| | | | | |
Collapse
|
14
|
Abstract
Objective: To evaluate temporal bone histopathology in infants with congenital heart defects (CHD). Study Design and Setting: A retrospective review of our temporal bone collection was conducted to identify temporal bones acquired from infants with CHD. Subjects were divided into nonsyndromic and syndromic CHD groups. The presence of temporal bone abnormalities and the incidence of abnormalities that may result in hearing impairment were determined. Results: Thirty-eight temporal bones obtained from 16 infants with nonsyndromic CHD and 4 with syndromic CHD were evaluated. Nonsyndromic CHD cases had abnormalities such as a mesenchymal remnant, malformed stapes, persistent stapedial artery, shallow round window, dehiscent facial nerve canal, short cochlea, strial basophilic deposits, deformity of the spiral ligament, bulging Reissner's membrane, hypoplastic lateral semicircular canal, and cupular deposits. Syndromic CHD cases had abnormalities including narrow round window niche, facial canal dehiscence, strial basophilic deposits and cysts, and outer hair cell loss. Middle and inner ear abnormalities that may impair hearing were observed in 6 subjects with nonsyndromic CHD and in 1 subject with syndromic CHD. Conclusions: A wide variety of temporal bone defects were documented in infants with CHD. Congenital middle and inner ear abnormalities should be anticipated in the hearing assessment and otologic surgery of infants with CHD.
Collapse
Affiliation(s)
- Seckin O Ulualp
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-9035, USA
| | | | | |
Collapse
|
15
|
Abstract
Congenital cholesteatoma is one of the more common causes of the onset of childhood conductive hearing loss unrelated to middle ear effusion. If undiagnosed, the disease can progress to irreversibly destroy the conductive hearing architecture, as well as the surrounding skull base of the lateral temporal bone. When diagnosed early, the growth can be removed and the conductive hearing mechanism preserved in the vast majority of patients. Because most children are asymptomatic, the burden falls on primary care providers to perform pneumatic otoscopy and visualize all quadrants of the tympanic membrane even in young children who frequently resist attempts to conduct a thorough examination to rule out suspicious lesions. [Pediatr Ann. 2016;45(5):e167-e170.].
Collapse
|
16
|
Nortjé CJ. Maxillo-facial radiology case 123. SADJ 2014; 69:328. [PMID: 26548215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
17
|
Tu B, Jiang L, Ma Y. [Evaluation on the virtual CT endoscopy of the simple congenital malformation and its clinical application]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:958-960. [PMID: 25248260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To evaluate the preoperative virtual CT endoscopy about the simple congenital middle ear malformations and its clinical application. METHOD Thirteen cases (16 ears) with simple congenital middle ear malformations were undergone high resolution CT scannig to collect the original image data, followed by 3-dimensional reconstruction to process the images to evaluate the possible lesions of the ossicular chain. Then, a comparative analysis was made between the finding of virtual CT endotoscopic and the finding that actually found during the operation of the ossicular chain lesions. RESULT We found malleus and upper strcture of incus abnormity or embeded in upper inner wall of atticus in 5 ears; malleus, incus and stape all abnormity or absence in 3 ears, in the former two conditions we both selected auricular incision through attic pathway remaining intact canal wall; we found crus longum incudis hypoplasia orstructure suprastapedialis absence,stapes aberrance or absence in 8 ears, then we selected vestibular window fenestration and artificial stapes surgery. Postoperative external auditory canals and tympanic membranes were intact in 16 ears,and speech frequency hearing improved by average of 25-45 dB. The coincidence between virtual CT endoscopy and the ossicular chain abnormity under operating views were 100% in cases with congenital ear deformity. CONCLUSION Virtual CT endoscopy is a reliable reference for preoperative evaluation on congenital middle ear malformations.
Collapse
|
18
|
Esteves SDS, Silva APD, Coutinho MB, Abrunhosa JM, Sousa CAE. Congenital defects of the middle ear - uncommon cause of pediatric hearing loss1,2. Braz J Otorhinolaryngol 2014; 80:251-6. [PMID: 25153111 PMCID: PMC9535481 DOI: 10.1016/j.bjorl.2013.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 10/01/2013] [Indexed: 12/22/2022] Open
Abstract
Introduction In children, hypoacusis, or conductive hearing loss, is usually acquired; otitis media with effusion is the most common etiology. However, in some cases this condition is congenital, ranging from deformities of the external and middle ear to isolated ossicular chain malformations. The non-ossicular anomalies of the middle ear, for instance, persistent stapedial artery and anomaly of the facial nerve, are uncommon but may accompany the ossicular defects. Objective This study aimed to describe the clinical presentation, diagnostic tests, and therapeutic options of congenital malformations of the middle ear. Methods This was a retrospective study of cases followed in otolaryngologic consultations since 2007 with the diagnosis of congenital malformation of the middle ear according to the Teunissen and Cremers classification. A review of the literature regarding the congenital malformation of the middle ear and its treatment is presented. Conclusion Middle ear malformations are rarely responsible for conductive hearing loss in children. As a result, there is often a late diagnosis and treatment of these anomalies, which can lead to delays in the development of language and learning.
Collapse
|
19
|
Ji S, Ou Y, Xu Y, Zheng Y. [The influence of congenital malformation of external and middle ear on the psychologic status of children patients]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:450-452. [PMID: 25026819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE This research focuses on the psychologic status of children patients with congenital malformation of external and middle ear by Achenbach's Child Behavior Checklist (CBCL) in order to explore the degree of the influence. METHOD The 66 patients of 4-16 years old were assessed psychologic status with CBCL filled in by their parents according to their performance in half a year. Then calculated the detection rate of behav ioral disorders of these patients. Collected all patients' general information and Marx's grade of malformed ears. Then analyzed the relationship between the detection rate and these factors. RESULT The detection rate of behavioral disorders of 4-16 years old patients, 21.21%, which is higher than that of Chinese norm. The Marx's grade and parents' mental stress relate with the behavioral disorders. In Logistic regression analysis, the value of Cox & Snell coefficient of the regression model is 0. 153. The detection rate of behavioral disorders in grade III patients (36.4%) is greater than that of grade II (4.3%), P = 0.004. CONCLUSION Congenital malformation of external and middle ear has an absolute influence on the patients' psychologic status, but its effect is only about 15% parts of the multitudinous influential factors. And grade III patients carry a high-risk for behavioral disorders.
Collapse
|
20
|
Mileshina NA, Osipenkov SS, Bakhshinian VV, Tavartkiladze GA. [Novel possibilities for the rehabilitation of patients presenting with congenital external and middle ear malformations]. Vestn Otorinolaringol 2014:33-36. [PMID: 24781169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The objective of the present study was to estimate the advantages of cochlear Baha BIA 400 abutments in the intraoperative and early postoperative periods. A total of 10 implantations of the systems with the use of hydroxyapatite bone cement were performed in 9 patients of different age. Stability of the implants and intensity of skin reactions were evaluated. The data obtained indicate that the use of cochlear Baha BIA 400 abutments significantly simplifies and shortens the surgical stage of rehabilitation producing a good cosmetic result. The use of the Osstell instrument made it possible to estimate stability of the implants intraoperatively and evaluate the effectiveness of osteointegration during the follow-up period. Analysis of the results of the study provided a basis on which to improve the quality and shorten duration of the rehabilitative treatment of the patients presenting with congenital external and middle ear malformations. Moreover, the data obtained can be used to develop practical recommendations for the further work in this area.
Collapse
|
21
|
Takegoshi H. Imaging diagnosis. Adv Otorhinolaryngol 2013; 75:13-19. [PMID: 24135343 DOI: 10.1159/000350594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Hideki Takegoshi
- National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan
| |
Collapse
|
22
|
Zhao S, Wang D. [Long-term following-up of auricle reconstruction and auditory rehabilitation in patients with congenital dysplasias of the external and middle ear]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 27:1045-1047. [PMID: 24417159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
23
|
Roberson JB, Goldsztein H, Balaker A, Schendel SA, Reinisch JF. HEAR MAPS a classification for congenital microtia/atresia based on the evaluation of 742 patients. Int J Pediatr Otorhinolaryngol 2013; 77:1551-4. [PMID: 23931903 DOI: 10.1016/j.ijporl.2013.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/03/2013] [Accepted: 07/05/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Describe anatomical and radiological findings in 742 patients evaluated for congenital aural atresia and microtia by a multidisciplinary team. Develop a new classification method to enhance multidisciplinary communication regarding patients with congenital aural atresia and microtia. METHODS Retrospective chart review with descriptive analysis of findings arising from the evaluation of patients with congenital atresia and microtia between January 2008 and January 2012 at a multidisciplinary tertiary referral center. RESULTS We developed a classification method based on the acronym HEAR MAPS (Hearing, Ear [microtia], Atresia grade, Remnant earlobe, Mandible development, Asymmetry of soft tissue, Paralysis of the facial nerve and Syndromes). We used this method to evaluate 742 consecutive congenital atresia and microtia patients between 2008 and January of 2012. Grade 3 microtia was the most common external ear malformation (76%). Pre-operative Jahrsdoerfer scale was 9 (19%), 8 (39%), 7 (19%), and 6 or less (22%). Twenty three percent of patients had varying degrees of hypoplasia of the mandible. Less than 10% of patients had an identified associated syndrome. CONCLUSION Patients with congenital aural atresia and microtia often require the intervention of audiology, otology, plastic surgery, craniofacial surgery and speech and language professionals to achieve optimal functional and esthetic reconstruction. Good communication between these disciplines is essential for coordination of care. We describe our use of a new classification method that efficiently describes the physical and radiologic findings in microtia/atresia patients to improve communication amongst care providers.
Collapse
Affiliation(s)
- Joseph B Roberson
- California Ear Institute, 1900 University Avenue Suite 101, E Palo Alto, CA 94303, United States.
| | | | | | | | | |
Collapse
|
24
|
Wang Z, Yang J, Wu H. [Congenital malformations of the external and middle ear]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 27:681-684. [PMID: 24073571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Congenital malformations of the external and middle ear is the common reason of pediatric hearing impairment and cosmic problem. The treatment composes of auricular plastic surgery and auditory reconstruction surgery. The use of BAHA, vibrant sound-bridge and tissue engineering materials can significantly improve the treatment outcomes.
Collapse
|
25
|
Wang D, Wang Q. [Advances in genetics of congenital malformation of external and middle ear]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 27:498-504. [PMID: 23898623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Congenital malformation of external and middle ear is a common disease in ENT department, and the incidence of this disease is second only to cleft lip and palate in the whole congenital malformations of the head and face. The external and middle ear malformations may occur separately, or as an important ear symptom of the systemic syndrome. We systematically review and analysis the genetic research progress of congenital malformation of external and middle ear, which would be helpful to understand the mechanism of external and middle ear development, and to provide clues for the further discovery of new virulence genes.
Collapse
|
26
|
Xu X, Jiang Z, Ma H, Yan D, Chen X, Xu Y, Zheng Y. [The study between temporal bone HRCT and operations in congenital abnormality of external and middle ear]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 27:355-358. [PMID: 23833987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE We explore the deformity degrees of external ear, mastoid process, tympanic cavity and auditory ossicle by the HRCT features of bilateral and unilateral patients of congenital abnormality of external and middle ear for preoperative analysis and selection for surgical approaches. METHOD Twenty-nine patients were enrolled in our study, and HRCT were performed on all patients. There were 23 unilateral ears deformity (13 right and 10 left), 6 patients with bilateral ears deformity in the study group. Nineteen patients (19 ears) were treated with operations. RESULT The deformity degree of auricle was correlated with that of external auditory meatus, and mastoid process develops bad aeration extent with bad tympanic cavity development in 35 ears in our research. We got data of shortest distance from tympanic cape to atresia board in HRCT, (0.59 +/- 0.13)cm in comparison group, (0.45 +/- 0.19)cm in unilateral deformity group, (0.32 +/- 0.12)cm in bilateral deformity group, and there were significant differences compared the two deformity groups with the comparison group. There were 1 ear with normal auditory ossicle (2.86%), 5 ears with fixation of stapes foot board (14.29%), 3 ears with no auditory ossicle (8.57%); 26 ears with malleus and incus abnormality (74.29%). Abnormality of malleus was always concomitant with that of incus. Degeneration of malleus, the joint amalgamation of malleus and incus were discovered mostly in this research. CONCLUSION The deformity degree of auricle is correlated with that of external auditory meatus, and mastoid process develops bad aeration extent with bad tympanic cavity development in 35 ears in our research. The shortest distance from tympanic cape to atresia board in HRCT in unilateral ears deformity group are shorten 0.15 cm in that of comparison group. And that of bilateral ears deformity group are shorten 0.25 cm in that of comparison group. The main abnormality of auditory ossicle in our research present in both malleus and incus, and degeneration of malleus and the joint amalgamation of malleus and incus are main types.
Collapse
Affiliation(s)
- Xiujuan Xu
- Department of Otorhinolaryngology, Chinese Medicine Hospital of Jiangsu Province, Nanjing 210029, China
| | | | | | | | | | | | | |
Collapse
|
27
|
Talyshinskiĭ AM, Talyshinskiĭ AA, Abbasova AA. [Multichamber otogenic brain abscess in the patients presenting with the congenital defect of external and middle ears]. Vestn Otorinolaringol 2013:91-94. [PMID: 24429869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
28
|
Chen SB, Zhao SQ, Wang DN. Duplication anomaly of the external auditory canal involving the middle ear. Chin Med J (Engl) 2013; 126:2987-2989. [PMID: 23924480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
- Shu-bin Chen
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University; Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China
| | | | | |
Collapse
|
29
|
Yuan YY, Song YS, Chai CM, Shen WD, Han WJ, Liu J, Wang GJ, Dong TX, Han DY, Dai P. Intraoperative CT-guided cochlear implantation in congenital ear deformity. Acta Otolaryngol 2012; 132:951-8. [PMID: 22668345 DOI: 10.3109/00016489.2012.674214] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS Intraoperative computed tomography (iCT)-guided cochlear implantation is practical and effective for correct electrode placement in the cochlea of patients with congenital inner ear and/or complex middle ear malformation. OBJECTIVES The operation in patients with inner ear and/or complex middle ear malformation including abnormal facial nerve course is difficult. This study evaluated the efficacy of cochlear implantation under the guidance of iCT to insure correct electrode placement. METHODS This was a prospective interventional case series. Ten patients with severe to profound sensorineural hearing loss due to ear malformations were enrolled, and iCT was used to confirm the right placement of electrodes. RESULTS Intraoperative CT was performed three times in one patient, twice in two, and once in the others. Interruption of the surgical process for each iCT until resumption of surgery was 9.64 ± 0.63 min. iCT revealed incorrectly positioned cochlear implants in two patients, which were immediately corrected. There were no reoperations due to misplacement of electrodes. iCT helped locate the cochlea in the middle ear of one patient with an abnormal facial nerve course. The overall intervention rate based on iCT findings was 30%. LEVEL OF EVIDENCE level 4.
Collapse
MESH Headings
- Adult
- Child
- Child, Preschool
- China
- Cochlear Implantation/methods
- Deafness/congenital
- Deafness/diagnostic imaging
- Deafness/physiopathology
- Deafness/surgery
- Ear, Inner/abnormalities
- Ear, Inner/diagnostic imaging
- Ear, Inner/physiopathology
- Ear, Inner/surgery
- Ear, Middle/abnormalities
- Ear, Middle/diagnostic imaging
- Ear, Middle/physiopathology
- Ear, Middle/surgery
- Electrodes, Implanted
- Facial Nerve/abnormalities
- Facial Nerve/physiopathology
- Facial Nerve/surgery
- Female
- Hearing Loss, Sensorineural/congenital
- Hearing Loss, Sensorineural/diagnostic imaging
- Hearing Loss, Sensorineural/physiopathology
- Hearing Loss, Sensorineural/surgery
- Humans
- Infant
- Male
- Postoperative Complications/diagnostic imaging
- Postoperative Complications/physiopathology
- Surgery, Computer-Assisted/methods
- Telemetry
- Tomography, X-Ray Computed/methods
Collapse
Affiliation(s)
- Yong-Yi Yuan
- Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
FAN Y, CHEN XW, YANG H, ZHANG ZY, ZHU XL, CAO KL, GAO ZQ. [Efficacy in patients with outer and middle ear deformities of using bone-anchored hearing aids]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 47:265-269. [PMID: 22800340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the efficacy and satisfaction of bone-anchored hearing aids (BAHA) in patients with outer and middle ear deformities. METHODS Seven patients with bilateral microtia and aural atresia, and three patients with unilateral microtia and bilateral middle ear malformation were fitted with soft-band BAHA for a few months, followed by receiving unilateral BAHA implantation. Mean pure-tone thresholds and speech audiometry tests results were compared among patients without hearing aid, with soft-band BAHA, and with implanted BAHA. Scores from the BAHA users' questionnaires and Glasgow children's benefit inventory (GCBI) were used to measure patient satisfaction and subjective health benefit. RESULTS The mean pure-tone thresholds of the patients were (64.8 ± 5.9) dBHL for those without hearing aid, (30.2 ± 3.7) dBHL for those with soft-band BAHA, and (20.3 ± 3.9) dBHL for those with implanted BAHA. The average decline in pure-tone threshold was (36.2 ± 8.0) dBHL for those with soft-band BAHA, and an additional decline of (12.2 ± 3.4) dBHL was achieved with implanted BAHA. The average gains in speech discrimination scores (SDS) were (3.00 ± 1.07)% for those without hearing aids and (89.39 ± 5.83)% for those with implanted BAHA in sound field of 45dBHL. SDS were (57.55 ± 10.30)% for those without hearing aids and (91.19 ± 4.16)% for those with implanted BAHA in sound field of 65dBHL. The average gains in SDS were (88.21 ± 6.86)% and (38.04 ± 7.56)% tested with 45dBHL and 65dBHL respectively. Sound reception thresholds (SRT) without hearing aids were (63.1 ± 5.9) dBHL and (24.7 ± 3.5) dBHL for those with implanted BAHA. The average gains in SRT was (39.6 ± 6.2) dBHL. The BAHA application questionnaire demonstrated excellent patient satisfaction. The general benefit score was 35.59 ± 14.35. CONCLUSION BAHA remains one of the most reliable methods of auditory rehabilitation and improves quality of life for patients with ear deformities.
Collapse
Affiliation(s)
- Yue FAN
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | | | | | | | | | | | | |
Collapse
|
31
|
Ren YY, Zhao SQ, Xue YB. [Survey of quality of life scale for patients with congenital ear malformation]. Zhonghua Yi Xue Za Zhi 2012; 92:269-271. [PMID: 22490801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To explore the congenital ear malformation (CEM)-specific quality of life (QOL) and examine the effects of total ear reconstruction surgery for QOL of CEM patients. METHODS A self-composed QOL scale was used for 129 patients with congenital external and middle ear malformation. All patients were requested to fill in the QOL scale before and 1 month after ear reconstruction surgery. RESULTS The level of QOL varied according to the degree of ear malformation. The total QOL score of patients with unilateral and bilateral CEM was 28.5 ± 18.4 and 51.6 ± 23.6, respectively. The total QOL score of patients pre- and post-operation was 21.0 ± 14.0 and 14.2 ± 9.7 respectively. Physiological functions, psychological status and social interactions of the patients were of statistical significance after ear reconstruction surgery compared to that of at pre-operation. CONCLUSION Congenital ear malformation-specific QOL scale can show sensitively the changes of QOL of CEM patients. And ear reconstruction surgery is beneficial for the patients.
Collapse
Affiliation(s)
- Yuan-yuan Ren
- Department of Otorhinolaryngology, Head & Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology, Head & Neck Surgery, Ministry of Education, Beijing 100730, China
| | | | | |
Collapse
|
32
|
Kulakova LA, Bodrova IV. [A case of congenital (juvenile) otosclerosis]. Vestn Otorinolaringol 2012:69-70. [PMID: 22810644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The present paper reports a case of congenital (juvenile) otosclerosis. This pathology is known to occur in 10% of the patients and cause severe hearing impairment. Precise diagnostics of the activity and extent of the otosclerotic process based on the results of functional multispiral computed tomography (MSCT) enables the practicing surgeons to identify indications for the surgical intervention, choose the adequate method and time for its performance, and make prognosis of its outcome. This inference is confirmed by the clinical observation described in this communication.
Collapse
|
33
|
Rusetskiĭ II, Latysheva EN, Lopatin AS, Bodrova IV. [The use of functional multispiral computed tomography for differential diagnostics of otosclerosis and congenital malformation of the internal and middle ear (a case report)]. Vestn Otorinolaringol 2012:76-78. [PMID: 22810647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This paper reports a rare clinical observation of congenital malformation of the internal and middle ear diagnosed with the help of functional multispiral computed tomography (fMSCT). The patient presenting with conductive hearing loss was suspected to have otosclerosis. However, the use of fMSCT made it possible to arrive at a more precise diagnosis, that is congenital malformation of the internal and middle ear that clinically manifested itself as the conductive loss of hearing. It was decided to refrain from the surgical intervention: first, because its efficacy in this case was considered to be doubtful and second, it was fraught with the high risk of development of postoperative complications.
Collapse
|
34
|
Kim DW, Lee JH, Song JJ, Chang H, Choi YS, Jang JH, Kim JH, Oh SH, Chang SO. Continuity of the incudostapedial joint: a novel prognostic factor in postoperative hearing outcomes in congenital aural atresia. Acta Otolaryngol 2011; 131:701-7. [PMID: 21351820 DOI: 10.3109/00016489.2011.552920] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Mean incudostapedial joint (ISJ) angulation of atretic ears was statistically wider than ISJ angulation of non-atretic ears. Postoperative hearing results in the narrow tympanoplasty type II (T2) subgroup were better than those in the wide T2 subgroup. In cases of abnormally wide ISJ angulation, we recommend that partial ossicular reconstruction (POR) be used as a surgical means of achieving hearing improvement. OBJECTIVE To report the results of ISJ angulation in patients with congenital aural atresia and its effects on postoperative hearing improvement. METHODS Patients undergoing canaloplasty with T2 (149 ears) and canaloplasty with POR (32 ears) were enrolled. The T2 group was dichotomized according to an ISJ cut-off of an angle of 120° into the 'narrow' T2 and 'wide' T2 subgroups. The pre- and postoperative air-bone gap (ABG) and ABG change were analyzed. RESULTS Mean ISJ angulation of non-atretic ears was 93.06 ± 13.21° and that of atretic ears in the T2 group was 118.39 ± 19.60° (p < 0.001). Mean short- and long-term postoperative ABGs were better in the narrow T2 subgroup than in the wide T2 subgroup (p = 0.01 and 0.03, respectively). The short-term postoperative ABG and ABG change in the POR showed superior results to those of the wide T2 subgroup (p < 0.001 and 0.041, respectively).
Collapse
Affiliation(s)
- Dong Wook Kim
- Department of Otorhinolaryngology, Seoul National University Hospital, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Gao RZ, Fan Y, Chen XW. [Advances in diagnosis and surgical treatment of congenital malformation of the external and middle ear]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 46:600-605. [PMID: 22088299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|
36
|
Han J, Lu JX, Xing N, Lin L, Jiang HY, Zhuang HX. [Sectional anatomical analysis of auricular and middle ear malformation in patients with microtia]. Zhonghua Zheng Xing Wai Ke Za Zhi 2011; 27:217-221. [PMID: 21838005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To analyze the sectional anatomical features of auricular and middle ear malformation in patients with microtia so as to improve the clinical classification and the instruction of surgery. METHODS From Jun. to Dec. 2009, 36 cases with microtia were selected in the center of auricular reconstruction in Plastic Surgery Hospital, including 22 cases of unilateral microtia and 14 cases of bilateral microtia. 22 patients with unilateral microtia were studied with the contralateral healthy ears as controls. Spiral CT was performed for high-resolution scan of the temporal bone. The coronal, sagittal and 3D reconstruction images were created with Mimic software. Several distances and degrees were measured. RESULTS The patients were classified by Max classification. The anteroposterior diameter and the vertical diameter of tympanic cavity were (7.75 +/- 1.92) mm and (14.66 +/- 4.75) mm for type I; (6.17 +/- 2.56) mm and(14.35 +/- 5.12) mm for type II; (6.31 +/- 3.40) mm and (9.97 +/- 4.36) mm for type III (P = 0.001). The mastoid pneumatization degree for type I, II, III were 13.33%, 13.64%, 30.77% in sclerotic type, 13.33%, 18.18%, 7.69% in diploe type, 0, 9.09%, 38.46% in composite type, 73.33%, 59.09%, 23.08% in pneumatic type (chi2 = 24.11, P = 0.002). The cover of fenestra vestibuli by facial nerve was 21.43%, 47.62%, 54.55% (chi2 = 23.44, P = 0.002) for type I, II, III. There was a statistical difference between the microtia group and the control group. CONCLUSIONS According to the Max classification, the middle ear malformation changed along the auricular malformation. The anatomical variations was complicated in type II microtia, which should be sub-classified.
Collapse
Affiliation(s)
- Juan Han
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100144, China
| | | | | | | | | | | |
Collapse
|
37
|
[Congenital malformations of the ear--state-of-the-art review]. Vestn Otorinolaringol 2011;:56-7. [PMID: 22433690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The rehabilitative treatment of the children presenting with congenital malformations of the external and middle ear requires the use of up-to-date technologies for diagnostics, surgical interventions, and prosthetic treatment in combination with genetic counseling. Many problems related to these issues remain unresolved despite recent progress in this field.
Collapse
|
38
|
Sun JJ, Zhao J. [Congenital external and middle ear malformation]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:700-704. [PMID: 21055257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
39
|
Ren YY, Zhao SQ. [Development and evaluation of a quality of life scale specific to patients with congenital external and middle ear malformation]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:623-627. [PMID: 21055235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To develop a quality of life scale for patients with congenital external and middle ear malformation, and to explore its reliability and validity. METHODS The initial quality of life scale for patients with congenital external and middle ear malformation was constructed based on quality of life scales from home and abroad. A total of 140 patients with congenital external and middle ear malformation had been recruited in the study. After pretest and item sifting, the quality of life scale was constructed, and its reliability and validity were evaluated. RESULTS Eighteen-item quality of life scale for patients with congenital external and middle ear malformation was constructed, which included three parts: physiological function, psychological status and social interaction. The retest reliability was 0.878; split-half reliability coefficient and Cronbach's alpha coefficient were 0.927 and 0.899, respectively. The results of factor analysis showed satisfactory construct validity. The reliability and validity of this scale was consistent with the demands of psychometrics. CONCLUSION Congenital external and middle ear malformation quality of life scale is believable and effective, which can be used for clinical practice.
Collapse
Affiliation(s)
- Yuan-yuan Ren
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | | |
Collapse
|
40
|
Abstract
CONCLUSION The Vibrant Soundbridge offers an excellent audiologic rehabilitation for toddlers with microtia and atresia. It provides direct stimulation of the cochlea and straightforward adaption to the given anatomical structures. The 'posterior atresia incision' preserves the physical integrity of the tissue layers around the ear remnant, which is essential for an aesthetic auricular reconstruction. OBJECTIVES Patients with bilateral aural atresia require immediate auditory stimulation to ensure normal speech development. We present an operative technique that allows safe restoration of hearing before aesthetic reconstruction. METHODS A 6-year-old boy presented with bilateral microtia and osseous atresia. A hairline incision was performed through all layers and was followed by a subperiostal preparation towards the atresia plane. The fused malleus-incus-complex was removed and the transducer was crimped to the stapes suprastructure on both sides. RESULTS Speech performance is nearly normal in both quiet and noise conditions. The surgery did not affect the tissues that are important for the later ear reconstruction.
Collapse
Affiliation(s)
- Henning Frenzel
- Department of Otorhinolaryngology and Plastic Operations, University Hospital Schleswig-Holstein, Lübeck, Germany.
| | | | | | | |
Collapse
|
41
|
Kong WJ. [Clinical decisions on diagnosis and treatment of congenital external and middle ear malformation]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:617-618. [PMID: 21055233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
42
|
Wang HB, Fan ZM. [Treatment of congenital external auditory canal and middle ear malformation]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:619-622. [PMID: 21055234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
43
|
Fu YY, Zhang TY, Dai PD, Hao SJ, Chi ZC. [Analysis of correlation between congenital auricular deformities and middle ear malformations]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:628-631. [PMID: 21055236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To explore the potential value of knowing the relationship between congenital auricular deformities and middle ear malformations. METHODS A total of 86 patients with congenital auricular deformities and middle ear malformations, including 51 males and 35 females, were admitted from January 2008 to December 2009 to the Eye Ear Nose and Throat Hospital of Fudan University. Fifty-eight patients had unilateral deformities (R:L = 34:24), while 28 were bilateral. One hundred and fourteen ears with congenital auricular deformities were included. High-resolution CT (HRCT) data was obtained from each patient. The auricular deformities were classified into three grades using the Marx H classification system. The modified Jahrsdoerfer grading system was used to score the malformations using HRCT data. The correlation between the grades of auricular deformities and scores of middle ear malformations was analyzed using Spearman rank correlation analysis. RESULTS The Marx H grades of congenital auricular deformities were 12 patients with grade I, 25 patients with grade II and 77 patients with grade III, while their corresponding Jahrsdoerfer scores were 7.8 ± 2.4, 6.8 ± 2.6 and 6.0 ± 2.8, respectively. The statistical analysis suggested a trend of negative correlation between the Marx H grades of auricular deformities and the Jahrsdoerfer scores of middle ear malformations (r = -0.2386, P = 0.0106). CONCLUSION There was a trend to a negative correlation between congenital auricular deformities and middle ear malformations.
Collapse
Affiliation(s)
- Yao-yao Fu
- Department of Otorhinolaryngology Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | | | | | | | | |
Collapse
|
44
|
Abstract
BACKGROUND Surgery for major malformations of the outer and middle ear involves aesthetic as well as functional aspects. Whereas reconstruction of the auricle with autogenous rib cartilage is well established and has shown favorable results, functional repair using classic reconstructive techniques is possible only in a limited group of patients and the outcome is often unsatisfactory. Active middle ear implants (MEI) offer a promising alternative to reconstructive surgery. METHOD Fifteen patients with ear malformations underwent implantation of an active middle ear implant (Soundbridge), with or without concomitant reconstruction of the auricle. The vibrating element, the floating mass transducer (FMT), was coupled either to the round window, stapes, oval window or incus, according to each individual's anatomical middle ear situation. Aesthetic as well as functional outcomes were evaluated. RESULTS Implantation could be integrated into aesthetic reconstruction of the auricle without complications. In 14/15 patients, a satisfactory functional result could be achieved (< 30 dB pure-tone audiometry). Neither facial nerve palsy nor inner ear hearing loss was observed after implantation. CONCLUSION The versatile form of the FMT of the Soundbridge allows for adaptation of the coupling procedure to the individual anatomical situations. Implantation of a Soundbridge MEI is a valuable option for functional reconstruction of the malformed ear, which may offer more consistent and reliable results than classic reconstructive surgery.
Collapse
|
45
|
Shilenkov AA. [Surgical treatment of congenital middle ear malformations]. Vestn Otorinolaringol 2010:39-41. [PMID: 20527089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
|
46
|
Kisilevsky V, Bailie NA, Dutt SN, Safar A, Halik JJ. The Markham-Stouffville hospital experience with malleovestibulopexy. J Otolaryngol Head Neck Surg 2009; 38:595-602. [PMID: 19958720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE To analyze the hearing results of malleovestibulopexy (MVP) technique in the special situations encountered in revision stapedotomies and congenital middle ear malformations. DESIGN Retrospective chart review. SETTING Tertiary referral stapes surgery center, community hospital. METHODS Audiometric results of 1369 stapedotomies performed in Markham-Stouffville Hospital during a period from 1991 to 2006 were reviewed. The results of 24 MVP procedures employed for revision stapedotomy or for congenital conductive hearing loss were included. MAIN OUTCOME MEASURES Air-bone gap (ABG) closure, air conduction (AC) gain, speech reception threshold (SRT) improvement. RESULTS Significant improvement in AC, ABG and SRT was demonstrated postoperatively. ABG closure within 20 dB was achieved in 61% of cases. One patient had transient postoperative vertigo. None of patients developed sensori neural hearing loss (SNHL) due to the surgery. CONCLUSION When surgical options for middle ear reconstruction are limited due to stapes immobility combined with absent or eroded incus, MVP offers a useful alternative enabling good hearing results. In our experience, the laser-assisted MVP technique is associated with low risk of postoperative SNHL and vestibular symptoms. This method offers a valuable adjunct to standard middle ear reconstruction techniques.
Collapse
Affiliation(s)
- Vitaly Kisilevsky
- Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Ontario
| | | | | | | | | |
Collapse
|
47
|
Cody JD, Heard PL, Crandall AC, Carter EM, Li J, Hardies LJ, Lancaster J, Perry B, Stratton RF, Sebold C, Schaub RL, Soileau B, Hill A, Hasi M, Fox PT, Hale DE. Narrowing critical regions and determining penetrance for selected 18q- phenotypes. Am J Med Genet A 2009; 149A:1421-30. [PMID: 19533771 DOI: 10.1002/ajmg.a.32899] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
One of our primary goals is to help families who have a child with an 18q deletion anticipate medical issues in order to optimize their child's medical care. To this end we have narrowed the critical regions for four phenotypic features and determined the penetrance for each of those phenotypes when the critical region for that feature is hemizygous. We completed molecular analysis using oligo-array CGH and clinical assessments on 151 individuals with deletions of 18q and made genotype-phenotype correlations defining or narrowing critical regions. These nested regions, all within 18q22.3 to q23, were for kidney malformations, dysmyelination of the brain, growth hormone stimulation response failure, and aural atresia. The region for dysmyelination and growth hormone stimulation response failure were identical and was narrowed to 1.62 Mb, a region containing five known genes. The region for aural atresia was 2.3 Mb and includes an additional three genes. The region for kidney malformations was 3.21 Mb and includes an additional four genes. Penetrance rates were calculated by comparing the number of individuals hemizygous for a critical region with the phenotype to those without the phenotype. The kidney malformations region was 25% penetrant, the dysmyelination region was 100% penetrant, the growth hormone stimulant response failure region was 90% penetrant with variable expressivity, and the aural atresia region was 78% penetrant. Identification of these critical regions suggest possible candidate genes, while penetrance calculations begin to create a predictive phenotypic description based on genotype.
Collapse
Affiliation(s)
- Jannine D Cody
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Wan LC, Guo MH, Xie NP, Liu SX, Chen H, Gong J, Chen SJ. [Effect of surgical reconstruction of congenital aural atresia via the mastoid antrum approach: analysis of 48 cases]. Nan Fang Yi Ke Da Xue Xue Bao 2009; 29:1057-1059. [PMID: 19460741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To assess the effect of surgical reconstruction of congenital aural atresia via the mastoid antrum approach and investigate method for preventing postoperative atresia of the reconstructed aural canal. METHODS From 2000 to 2008, aural canal reconstruction and tympanoplasty was performed via the mastoid antrum approach. In 48 patients with congenital aural atresia (54 ears, including 45 ears of type II, 9 ears of type III). All the patients were followed-up for 18 months to assess the therapeutic effect. RESULTS The mastoid antrum was located uneventfully for all the 54 ears, all showing ossicular chain anomalies involving most frequently the malleus and the incus followed by the upper structures of the stapes. Facial nerve abnormalities were seen in 23 ears (42.6%). Hearing improvement to over 20 dB was achieved in 45 ears (83.3%) and to over 25 dB in 25 ears (46.2%) one year later. CONCLUSION The mastoid antrum approach for surgical reconstruction of congenital aural atresia is safe and reliable. Maintenance of the width of the aural canal and prevention of lateral healing of the transplanted tympanic membrane are crucial in the treatment of congenital aural atresia.
Collapse
Affiliation(s)
- Liang-cai Wan
- Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China. wanliangcai@ 126.com
| | | | | | | | | | | | | |
Collapse
|
49
|
Korres SG, Balatsouras DG, Lyra CP, Korres GS, Kantas I, Papadakis CE. Hearing evaluation in newborns with congenital aural malformation. B-ENT 2009; 5:79-82. [PMID: 19670594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES Over 5 years, 68,472 newborns were screened through a newly implemented universal newborn hearing screening program. In 15 cases, atresia of the external ear canal was found. The aim of this study was to estimate the hearing status of these newborns using transiently evoked otoacoustic emissions (TEOAEs) and auditory brainstem responses (ABRs). METHODS TEOAEs were performed during the first days after birth in the normal ears of all newborns. Diagnostic ABR audiometry was performed in 10 newborns. RESULTS Unilateral involvement occurred in all newborns studied. TEOAEs were present in all the contralateral ears. Normal ABRs were recorded from the healthy ear, whereas a conductive hearing loss, of approximately 50-60 dB, was found in the involved ear. In long-term follow-up, a satisfactory level of hearing, language, and speech development was found in 9 of the newborns; it was too early to come to definite conclusions in 4 newborns and 2 newborns were lost in follow-up. CONCLUSIONS In this study, all newborns with aural atresia had normal function in the contralateral ear. Yet, a comprehensive assessment of hearing is essential as early intervention is necessary in the rare case of bilateral hearing impairment.
Collapse
Affiliation(s)
- S G Korres
- ENT Department of Athens National University, Hippokration Hospital, Athens, Greece
| | | | | | | | | | | |
Collapse
|
50
|
Zhang ZG, Zheng YQ, Liu X. [Hearing reconstruction simultaneous with implant lastly and prostheses for congenital microtia]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2008; 43:853-854. [PMID: 19267979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
|