Otology Japan
Online ISSN : 1884-1457
Print ISSN : 0917-2025
ISSN-L : 0917-2025
小児先天性耳小骨奇形の検討
加藤 健丹羽 英人
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ジャーナル フリー

2004 年 14 巻 3 号 p. 219-223

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We analyzed the results of 70 ears (54 cases) of the children with congenital ossicular malformation who was treated surgically between 1993 and 2003 in Nagoya National Hospital. The series included 18 male and 36 female patients. The age ditribution at the time of surgery ranged from 5 to 21 years, with an average of 10.1 years.
In exprolatory tympanotomy, there were various kinds of surgical findings. Epitympanic fixation found in 25 ears, ossicular detachment in 32 ears, stapes foot plate fixation in 43 ears, bony obliteration of the oval window niche in 2 ears, and the oval window niche covered with facial nerve in 1 ear. In these 70 ears, 27 ears had 2 or 3 ossicular malformation together.
We undertook various kinds of ossicular reconstructive surgery. We perfomed type I tympanoplasty in 7 ears, modified type III tympanoplasty in 17 ears, modified type IV tympanoplasty in 9 ears, modified type V tympanoplasty in 1 ear, stapedotomy in 22 ears, stapedectomy in 2 ears, stapedotomy with incus bypass method in 10 ears, and stapedectomy with incus bypass method in 2 ears. The postoperative hearing result showed that the mean air conduction at three frequencies (0.5kHz, 1kHz, 2kHz) was 29.7dB, the mean A-B gap was 17.7dB and the mean hearing gain was 23.7dB. The postoperative hearing improvement in air conduction within 30dBwas obtained in 48 ears (68.6%), the closure of A-B gaps within 15dB 43 ears (61.4%). 53 ears (75.7%) raised their hearing level at least 15dB after operation. 57 ears (81.2%) wereevaluated by the standard of the otological society of Japan as the improvement of hearinglevel.

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