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Stapes malformations: the contribute of the endoscopy for diagnosis and surgery


The aim of this study is to investigate the contribute of the endoscopic exclusive transcanalar approach for the management of stapes malformations. A retrospective chart review was made at our tertiary referral centers. 17 patients with stapes malformations underwent surgery with endoscopic exclusive transcanal approach. A complete audiological and radiological assessment before and after surgery was performed. 12/17 (70 %) underwent a surgical endoscopic correction, In case of fixed platina underwent five endoscopic stapedotomy and one endoscopic stapedectomy were performed. In case of mobile platina five endoscopic ossiculoplasties with partial ossiculoplasty replacement prosthesis were performed, 3 with autologous remodeling incus and 2 with malleus head remodeling. In 1 case, only an endoscopic stapes mobilization was made. In 5/17 (30 %), due to difficult anatomical findings an endoscopic explorative tympanotomy was finally performed. The mean preoperative air conduction (AC), bone conduction (BC) and air-bone gap (ABG) were, respectively, 60.7, 26.3 and 34.4 dB. The mean postoperative AC, BC and ABG were, respectively, 33.8, 26.5 and 7.3 dB, with a mean improvement of the ABG of 27.1 dB. Discharge from hospital was on the first post-surgery day. No relevant postoperative complications were noted. The median follow-up was 3.6 years (range 1–6). The endoscopic approach results very adequate for the diagnosis and treatment of stapes malformations, checking variations of the ossicles conformation and functioning and performing safe surgery, under direct control of middle ear structures.

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  1. 1.

    Teunissen EB, Cremers WR (1993) Classification of congenital middle ear anomalies: report on 144 ears. Ann Otol Rhinol Laryngol. 102(8, pt 1):606–612

  2. 2.

    Teunissen B, Cremers CW (1991) Surgery for congenital stapes ankylosis with an associated congenital ossicular chain anomaly. Int J Pediatr Otorhinolaryngol 21(3):217–226

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Teunissen B, Cremers WR, Huygen PL, Pouwels TP (1990) Isolated congenital stapes ankylosis: surgical results in 32 ears and a review of the literature. Laryngoscope 100(12):1331

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Park K, Choung YH (2009) Isolated congenital ossicular anomalies. Acta Otolaryngol 129(4):419–422

    Article  PubMed  Google Scholar 

  5. 5.

    Masuda S, Kodera K, Iino Y, Shidara J (1994) Computed tomography findings in middle ear anomaly. J Otolaryngol Jpn (in Japanese) 97:247–253

    CAS  Google Scholar 

  6. 6.

    Fisher NA, Curtin HD (1994) Radiology of congenital hearing loss. Otolaryngol Clin N Am 27:511–531

    CAS  Google Scholar 

  7. 7.

    Yuen HY, Ahuja AT, Wong KT, Yue V, van Hasselt AC (2003) Computed tomography of common congenital lesions of the temporal bone. Clin Radiol 58(9):687–693

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Hashimoto S, Yamamoto Y, Satoh H, Takahashi S (2002) Surgical treatment of 52 cases of auditory ossicular malformations. Auris Nasus Larynx 29:15–18

  9. 9.

    Boone R, Dornhoffer J (2002) Stapedotomy above the facial nerve in a congenitally malformed ear: a case report. Otolaryngol Head Neck Surg 127:342–345

    Article  PubMed  Google Scholar 

  10. 10.

    De La Cruz A, Angeli S, Slattery WH (1999) Stapedectomy in children. Otolaryngol Head Neck Surg 120:487–492

  11. 11.

    Marchioni D, Alicandri-Ciufelli M, Grammatica A, Mattioli F, Presutti L (2010) Pyramidal eminence and subpyramidal space: a dissection study. Laryngoscope 120(3):557–564

    Article  PubMed  Google Scholar 

  12. 12.

    Marchioni D, Mattioli F, Alicandri-Ciufelli M, Presutti L (2008) Endoscopic approach to tensor fold in patients with limited attic cholesteatoma. Acta Otolaryngol 25:1–9

    Google Scholar 

  13. 13.

    Marchioni D, Mattioli F, Alicandri-Ciufelli M, Presutti L (2009) Transcanal endoscopic approach to the sinus timpani: a clinical report. Otol Neurotol 30:758Y65

  14. 14.

    Raveh E, Hu W, Papsin BC, Forte V (2002) Congenital conductive hearing loss. J Laryngol Otol 116(2):92–96

    Article  PubMed  Google Scholar 

  15. 15.

    Hung KL, Tu TY, Tsai TL, Shiao AS (2003) Congenital ossicular anomalies. J Chin Med Assoc 66(8):474–479

    PubMed  Google Scholar 

  16. 16.

    Dornhoffer JL, Helms J, Hoehmann DH (1995) Stapedectomy for congenital fixation of the stapes. Am J Otol 16(3):382–386

    CAS  PubMed  Google Scholar 

  17. 17.

    Albert S, Roger G, Rouillon I, Chauvin P, Denoyelle F, Derbez R et al (2006) Congenital stapes ankylosis: study of 28 cases and surgical results. Laryngoscope. 116(7):1153–1157

    Article  PubMed  Google Scholar 

  18. 18.

    Briggs RJ, Luxford WM (1994) Correction of conductive hearing loss in children. Otolaryngol Clin North Am 27(3):607–620

    CAS  PubMed  Google Scholar 

  19. 19.

    Stewart JM, Downs MP (1993) Congenital conductive hearing loss: the need for early identification and intervention. Pediatrics 91(2):355–359

    CAS  PubMed  Google Scholar 

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These cases were derived from the Otolaryngology Department, University Hospital of Verona and Modena.

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Correspondence to Davide Soloperto.

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All of the authors have read and approved the manuscript. None of them have any financial relationships to disclose.

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Marchioni, D., Soloperto, D., Villari, D. et al. Stapes malformations: the contribute of the endoscopy for diagnosis and surgery. Eur Arch Otorhinolaryngol 273, 1723–1729 (2016).

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  • Stapes malformations
  • Conductive hearing loss
  • Endoscopic stapedotomy
  • Posterior mesotympanum anatomy
  • Middle ear endoscopic exploration