外耳奇形を伴わない先天性耳小骨固着 : その分類に関する一提案

概要

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Ten ears of congenital ossicular fixation without deformities of the external ear were presented. They were classified into two groups, three ears with malleus and/or incus fixation and seven with stapes fixations. The surgical treatment for the former group was to remove the axed part of the ossicles for the two ears and to mobilize the ossicle for the remained one. The removal of the fixed part yielded satisfactory results, but the mobilization failed to improve the hearing. Stapedectomy and the gelfoam wire prosthesis were performed for the group of stapes fixation. The result was relatively good in some cases with the normal shaped stapes, but it was not satisfactory in other cases with the malformed stapes. It was conjectured from the embryogenetic consideration that the malleus and/or the incus fixation was the results of disturbances in separation process by the undifferentiated mesenchyme surrounding the ossicles, and the stapes fixation was caused by maldevelopment of the stapedial lamina. The authors insist that this classification is practically valid as it would suggest the maldeveloped point in ossicular genesis and results of surgical treatment.
社団法人日本耳鼻咽喉科学会の論文