Objective: To explore the clinical characteristics, intervention and treatment of tympanic osteoma at different locations. Methods: The medical history, audiological and imaging examination, operation and follow-up results of two patients with tympanic osteoma at different sites were reviewed and summarized. Furthermore, the clinical characteristics and interventions of 36 patients reported in literatures with tympanic osteomas were also summarized and analyzed. Results: Osteoma of the two patients collected in this study located at promontory and incus respectively;both of them presented with intact tympanum and conductive deafness, without obvious etiology or predisposing factor. Both of them underwent surgeries and the hearing improved significantly. For patient one, the ossicular chain was intact and restored to activity after removed the osteoma. For patient two, an artificial ossicle was implanted after removed the osteoma and incus. In the 36 patients reported in literatures, the average age was 26.5 years, and 39.47% of them located at promontory; in addition, the main symptoms of them were progressive hearing loss, tinnitus and ear stuffy. Conclusions: Patients with tympanic osteoma are characterized by conduction deafness with intact tympanic membrane, and the most common lesion is promontory. Hearing can be restored by excision of the osteoma and maintenance or reconstruction of the ossicle chain.
Adult ; Ear Ossicles/surgery* ; Ear, Middle/surgery* ; Hearing Loss, Conductive/surgery* ; Humans ; Osteoma/surgery* ; Tympanic Membrane

A case of ear mold impression middle ear foreign body was reported. In the exploratory operation we found the ear mold impression surrounded the ossicular chains. During the process of removal the middle ear foreign body, the incudostapedial joint was protected from obvious external force and ossicular chains were kept integrity. Tympanoplasty was completed after management of foreign body. The patient recovered well postoperatively and was discharged as scheduled.
Ear Ossicles ; surgery ; Ear, Middle ; Female ; Foreign Bodies ; surgery ; Humans ; Middle Aged ; Tympanoplasty

Objective:For tympanosclerosis patients with ossicular chain fixation, we use ossicular chain bypass technique and evaluate its long-term effects. Methods:From June 2017 to June 2019, 147 patients with tympanosclerosis who underwent middle ear surgery with otoscopy in Yinchuan First People's Hospital were reviewed. The subjects were divided into three groups according to the implemented operation plan, 51 cases in the ossicular chain mobilization group（OCM）, 56 cases in the ossicular chain bypass reconstruction group（OCB）, and 40 cases in the malleus-incus complex resection reconstruction group（MICR）. Through a three-year follow-up, the medium and long-term effects of different operation plans were compared and analyzed. Results:There was no significant difference among the three groups in the incidence of tympanic membrane perforation, delayed facial nerve palsy, and the dispatch and displacement of PORP. The incidence of tympanic membrane retraction pocket or cholesteatoma after operation in OCB group（0） was significantly lower than that in OCM group（11.76%） and MICR group（7.5%）（P<0.05）. At 12 months after operation, ΔABG of OCB group and MICR group were better than that in the OCM group（P<0.05）. At 36 months after operation, ΔABG of OCB group was better than that in the OCM group（P<0.05）, and there was no significant difference between OCB group and MICR group. The audiological performance of patients with epitympanic sclerosis（ETS） at 12, 24 and 36 months after operation was better than that of patients with posterior tympanosclerosis（PTS） and total tympanosclerosis（TTS）（P<0.05）. Conclusion:Compared with patients undergoing ossicular chain mobilization and malleus-incus complex resection for ossicular chain reconstruction, patients with tympanosclerosis undergoing bypass technique have better and stable hearing prognosis in medium and long term. This technique can effectively prevent the formation of retracted pocket and cholesteatoma in patients with tympanosclerosis after operation.
Humans ; Tympanosclerosis ; Ear Ossicles/surgery* ; Ear, Middle ; Malleus/surgery* ; Cholesteatoma ; Retrospective Studies ; Ossicular Prosthesis ; Treatment Outcome

Tympanosclerosis is the hyaline degeneration and calcium deposition of the lamina propria of tympanic membrane and the submucosa of middle ear under long-term chronic inflammatory stimulation. At present, treatment primarily involves the surgical removal of sclerotic foci and reconstruction of auditory ossicular chain. However, excision of sclerotic lesions near critical structures like the facial nerve canal and vestibular window may result in complications like facial paralysis, vertigo, and sensorineural hearing loss. Developing safer and more effective treatments for tympanosclerosis has become an international research focus. Recent years have seen novel explorations in the treatment of tympanosclerosis. Therefore, this article reviews the latest advancements in research on the treatment of tympanosclerosis.
Humans ; Tympanoplasty ; Ear, Middle ; Ear Ossicles/surgery* ; Tympanic Membrane/surgery* ; Tympanosclerosis

Objective: To conclude the clinical features and the postoperative efficacy of congenital middle ear malformation treated with Malleostapedotomy (MS), and to explore the security and effectiveness of MS surgery. Methods: The clinical data of 17 patients (18 ears) with congenital middle ear malformation undergoing MS procedure were analyzed. There were 10 males (11 ears) and 7 females (7 ears), aged from 7 to 48 years. The imaging examination, pure-tone audiometry, intraoperative findings and postoperative hearing improvement of these patients were analyzed and summarized, and software SPSS23.0 was used for statistical analysis. Rusults All the 17 patients (18 ears) presented with hearing loss since childhood on the affected sides. Preoperative high resolution CT (HRCT) of the temporal bone revealed definite malformations in 9 ears (6 ears with incus long process dysplasia and 3 ears with anterior and posterior crus dysplasia). Before surgery, the mean bone conductive hearing threshold at 500, 1 000, 2 000 and 4 000 Hz was (15.6±10.2) dB HL, the mean air conductive hearing threshold was (60.6±9.7) dB HL, and the mean air-bone gap was (45.0±8.9) dB. During the surgery, all 18 ears were found to be accompanied by absence or hypoplasia of incus long process. 12 ears had stapes fixation, 6 ears had oval window atresia. All patients were treated with MS procedure by using Piston. The patients were followed up for 3 months to 1 year. The mean bone conductive hearing threshold was (14.7±8.8) dB HL. The mean air conductive hearing threshold was (37.7±11.6) dB HL, and the mean air-bone gap was (23.0±8.0) dB. There were statistically significant differences in the mean air conductive hearing threshold and mean air-bone gap before and after surgery (P<0.05). While there were no statistically significant differences in the mean bone conductive hearing threshold before and after surgery (P=0.550). Conclusions: MS procedure is safe and reliable in patients with congenital middle ear malformation of incus long process dysplasia, stapes fixation or oval window atresia. HRCT is useful in evaluating the major deformity of ossicular chain and facial nerve deformity. However, it is not enough to evaluate the joint of incus-stapes and oval window atresia. MS surgery in middle ear malformation requires advanced surgical experience and skills. The hearing improvement can be significant, even though some air-bone gap after surgery exist.
Child ; Ear Ossicles ; Ear, Middle/surgery* ; Female ; Hearing Loss, Conductive/surgery* ; Humans ; Male ; Retrospective Studies ; Stapes ; Treatment Outcome

OBJECTIVE: To investigate the diagnosis and treatment of the simple congenital malformation of ossicular chain. METHOD: Curative effect analysis for 4 cases of treatment of simple congenital malformation of ossicular chain were performed in our department from June 2005 to August 2009, retrospectively. 4 patients underwent middle ear exploration and ossicular chain reconstruction were followed up for 1-4 years, and air conduction threshold of speech frequency(0.5, 1.0, 2.0 kHz) were detected, 15 dB increase of which were as the standard of successful operation. RESULT: Three cases was abnormal incus, 2 cases were absence of instruction on the stapes footplates, and stapes footplates fixed, one case was absence of the incus. Hearing level had significantly improve after hearing reconstruction in 3 patients. The averaged postoperative air conduction threshold of speech frequency had 47 dB increase, bone conduction threshold have no change, while one case of hearing level without change. Tinnitus, vertigo, facial paralysis and other complications occurred were found in all the patients. CONCLUSION The congenital conductive hearing loss without external ear malformations should be suspected of congenital malformation of ossicular chain, which could be diagnosed by tympanic exploration. Ossicular chain reconstruction can improve the hearing effectively.
Adolescent ; Ear Ossicles ; abnormalities ; Hearing Loss, Conductive ; congenital ; diagnosis ; surgery ; Humans ; Male ; Retrospective Studies ; Young Adult

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.
Adolescent ; Child ; Child, Preschool ; Ear Ossicles ; abnormalities ; Ear, External ; abnormalities ; diagnostic imaging ; Ear, Middle ; abnormalities ; diagnostic imaging ; Humans ; Malleus ; abnormalities ; Radiography ; Temporal Bone ; diagnostic imaging ; surgery ; Young Adult

The Oto-palato-digital syndrome is a generalized skeletal dysplasia resulting in short stature, characteristic facies, and unusual deformities of the hands and feet. In addition, cleft palate and other congenital malformations are present. Some patients have conductive deafness due to dysplastic auditory ossicle which is sometimes stapes fixation. We experienced a case of Oto-palato-digital syndrome which showed bilateral stapes fixation, high-arched palate and syndactly of toes. Congenital stapes fixation was treated through partial stapedectomy with good hearing gain.
Cleft Palate ; Congenital Abnormalities ; Deafness ; Ear Ossicles ; Facies ; Foot ; Hand ; Hearing ; Humans ; Palate ; Stapes ; Stapes Surgery ; Toes

OBJECTIVE: To evaluate the therapeutic effects of epitympanum approach tympanotomy in treating traumatic ossicular chain disruption. METHOD: Ten patients with temporal bone fracture and trauma of ear, whose CT scan of temporal bone showed that Malleoincudal joint irregular shape in the axial view and incudostapedial joint dislocation in the coronal view, were included in this study, Virtual endoscopy showed Malleoincudal joint separation, incudostapedial joint dislocation and interruption, ossicular chain disruption in all patients. The surgical approach was opening the atticus via temporal line, remaining the intact posterior and superior wall of external acoustic meatus, exposing the atticus and posterior tympanic cavity sufficiently, and treating the lesions of ossicular chain. RESULT: One patient with the long process of the incus fracture, adopted the fitted incus prosthesis between the handle of the malleus and the head of the stapes. Six patients with Malleoincudal joint separation or incudostapedial joint dislocation, 3 patients with incus body dislocation completely, adopted incus positioning two articulation decis. The air-conducting hearing levels had an enhancement of 25-50dB in average after surgery. CONCLUSION The effect of intact canal wall epitympanum approach ossicular reposition in treating traumatic ossicular chain disruption is satisfying.
Adolescent ; Adult ; Ear Ossicles ; diagnostic imaging ; injuries ; surgery ; Ear, Middle ; diagnostic imaging ; surgery ; Female ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Ear Ventilation ; Temporal Bone ; diagnostic imaging ; injuries ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo explore the efficacy of total and partial ossicular chain reconstruction using titanium implants.

METHODSTotal of 106 patients (107 ears) underwent ossiculoplasty using titanium from June 2008 to January 2011. Eighty-six ears had partial ossicular replacement prosthesis (PORP) and 21 ears had total ossicular replacement prosthesis (TORP). Patient data were collected retrospectively from the database of surgical cases. Patients were assessed during 6 to 30 months postoperatively to establish middle- and long-term hearing results. Average postoperative air-conduction gain and air-bone gap (ABG) were measured at four frequencies: 0.5, 1, 2, and 4 kHz.

RESULTSPostoperative air-bone gap of 20 dB or less than 20 dB was obtained in 83.7% of PORP cases versus 71.4% of TORP cases. All the cases obtained significant postoperative air-conduction gains. The change in air-bone gap (defined as the difference between the means of preoperative and postoperative ABG) was 12.5 dB for PORP patients and 12.9 dB for the TORP patients. There was no statistically significant difference between the TORP and PORP groups. Prosthesis exclusion was observed in one case (0.9%).

CONCLUSIONProstheses using titanium type could give good functional results and stability with low exclusion rate to patients presenting chronic otitis media.

Adolescent ; Adult ; Audiometry ; Child ; Ear Ossicles ; surgery ; Female ; Hearing Loss, Conductive ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Ossicular Prosthesis ; Retrospective Studies ; Titanium ; Treatment Outcome ; Tympanoplasty ; methods ; Young Adult