Short‐process incudo‐stapedioplasty in congenital ear malformation

Abstract Objectives Although various stapedotomy and stapedectomy techniques exist, anchoring the piston can be challenging. We present a novel surgical approach for treating congenital stapes malformations with an atypical facial nerve trajectory. Methods This is a case of a 7‐year‐old boy presenti...

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Main Authors: Ryotaro Omichi, Shin Kariya, Akiko Sugaya, Mizuo Ando
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Laryngoscope Investigative Otolaryngology
Subjects:
Online Access:https://doi.org/10.1002/lio2.70055
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author Ryotaro Omichi
Shin Kariya
Akiko Sugaya
Mizuo Ando
author_facet Ryotaro Omichi
Shin Kariya
Akiko Sugaya
Mizuo Ando
author_sort Ryotaro Omichi
collection DOAJ
description Abstract Objectives Although various stapedotomy and stapedectomy techniques exist, anchoring the piston can be challenging. We present a novel surgical approach for treating congenital stapes malformations with an atypical facial nerve trajectory. Methods This is a case of a 7‐year‐old boy presenting with bilateral conductive hearing loss. Prior attempts at tympanoplasty had proven unsuccessful in improving his hearing. Presurgical imaging studies revealed an unusual anatomical configuration, with the facial nerve positioned inferior to the oval window. This anatomical variation precluded the use of conventional prosthesis‐anchoring techniques typically employed in stapedotomies. Thus, we devised an innovative approach, opting to anchor the prosthesis to the short process of the incus. Results This novel technique circumvented the atypical course of the facial nerve, allowing for successful reconstruction of the ossicular chain. The patient demonstrated an acceptable improvement (30 dB gain) in hearing 1‐year post‐surgery, with no reported complications. Conclusion This case underscores the critical importance of adapting surgical techniques to address the unique anatomical challenges that may arise in the context of congenital ear malformations. It also highlights the potential of the short process of the incus as a viable alternative anchoring site for stapes prostheses, thereby improving the outcomes of such complex cases. This technique not only restored the patient's hearing but also contributed valuable insights into the management of similar cases, potentially improving the quality of life for individuals with rare and challenging anatomical variations. Level of evidence 5.
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series Laryngoscope Investigative Otolaryngology
spelling doaj-art-1efe4366c6cd4dff9580a3353f9779ac2025-08-20T02:45:14ZengWileyLaryngoscope Investigative Otolaryngology2378-80382025-02-01101n/an/a10.1002/lio2.70055Short‐process incudo‐stapedioplasty in congenital ear malformationRyotaro Omichi0Shin Kariya1Akiko Sugaya2Mizuo Ando3Department of Otolaryngology‐Head and Neck Surgery, Dentistry and Pharmaceutical Sciences Okayama University Graduate School of Medicine Okayama JapanDepartment of Otolaryngology‐Head and Neck Surgery Kawasaki Medical School Okayama JapanDepartment of Otolaryngology‐Head and Neck Surgery, Dentistry and Pharmaceutical Sciences Okayama University Graduate School of Medicine Okayama JapanDepartment of Otolaryngology‐Head and Neck Surgery, Dentistry and Pharmaceutical Sciences Okayama University Graduate School of Medicine Okayama JapanAbstract Objectives Although various stapedotomy and stapedectomy techniques exist, anchoring the piston can be challenging. We present a novel surgical approach for treating congenital stapes malformations with an atypical facial nerve trajectory. Methods This is a case of a 7‐year‐old boy presenting with bilateral conductive hearing loss. Prior attempts at tympanoplasty had proven unsuccessful in improving his hearing. Presurgical imaging studies revealed an unusual anatomical configuration, with the facial nerve positioned inferior to the oval window. This anatomical variation precluded the use of conventional prosthesis‐anchoring techniques typically employed in stapedotomies. Thus, we devised an innovative approach, opting to anchor the prosthesis to the short process of the incus. Results This novel technique circumvented the atypical course of the facial nerve, allowing for successful reconstruction of the ossicular chain. The patient demonstrated an acceptable improvement (30 dB gain) in hearing 1‐year post‐surgery, with no reported complications. Conclusion This case underscores the critical importance of adapting surgical techniques to address the unique anatomical challenges that may arise in the context of congenital ear malformations. It also highlights the potential of the short process of the incus as a viable alternative anchoring site for stapes prostheses, thereby improving the outcomes of such complex cases. This technique not only restored the patient's hearing but also contributed valuable insights into the management of similar cases, potentially improving the quality of life for individuals with rare and challenging anatomical variations. Level of evidence 5.https://doi.org/10.1002/lio2.70055congenital ear malformationincusprosthesisstapedectomystapedotomy
spellingShingle Ryotaro Omichi
Shin Kariya
Akiko Sugaya
Mizuo Ando
Short‐process incudo‐stapedioplasty in congenital ear malformation
Laryngoscope Investigative Otolaryngology
congenital ear malformation
incus
prosthesis
stapedectomy
stapedotomy
title Short‐process incudo‐stapedioplasty in congenital ear malformation
title_full Short‐process incudo‐stapedioplasty in congenital ear malformation
title_fullStr Short‐process incudo‐stapedioplasty in congenital ear malformation
title_full_unstemmed Short‐process incudo‐stapedioplasty in congenital ear malformation
title_short Short‐process incudo‐stapedioplasty in congenital ear malformation
title_sort short process incudo stapedioplasty in congenital ear malformation
topic congenital ear malformation
incus
prosthesis
stapedectomy
stapedotomy
url https://doi.org/10.1002/lio2.70055
work_keys_str_mv AT ryotaroomichi shortprocessincudostapedioplastyincongenitalearmalformation
AT shinkariya shortprocessincudostapedioplastyincongenitalearmalformation
AT akikosugaya shortprocessincudostapedioplastyincongenitalearmalformation
AT mizuoando shortprocessincudostapedioplastyincongenitalearmalformation