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Review
. 2025 Oct 24.
doi: 10.1007/s00405-025-09765-3. Online ahead of print.

Empty oval window associated with ossicular malformation: Our experience and a review of the literature

Lucia Oriella Piccioni  1 , Roberto Teggi  1 , Anna Del Poggio  2 , Alex Finco  1   3 , Giulia Sgrò  1   3 , Rosa Alessia Battista  4   5
Affiliations
Review

Empty oval window associated with ossicular malformation: Our experience and a review of the literature

Lucia Oriella Piccioni et al. Eur Arch Otorhinolaryngol. .

Abstract

Purpose: Congenital malformations of the middle ear, particularly those affecting the ossicular chain and stapes, are uncommon yet significant causes of conductive hearing loss. Here, we report a unique case of stapes malformation with an empty oval window and provide a review of the literature to contextualize our findings.

Methods: We present the detailed diagnostic and therapeutic course of a 21-year-old female with unilateral conductive hearing loss, focusing on imaging, intraoperative findings, and management strategy. A comprehensive literature review (January 1950-January 2025) was undertaken in major databases.

Results: Preoperative high-resolution computed tomography (HRCT) revealed no apparent abnormalities. Exploratory tympanotomy, however, identified a malformed stapes located on the promontory, below an empty oval window covered by fibrous tissue. No bone was felt on palpation. In light of the risk for perilymphatic gusher and the moderate degree of hearing loss, surgical reconstruction was not performed. The patient was managed with hearing amplification, achieving satisfactory rehabilitation and no complications.

Conclusion: Malformations of the stapes and oval window demonstrate significant anatomical variability and can be difficult to diagnose using imaging alone. Surgical exploration remains crucial, and in the setting of an empty oval window, a tailored, conservative approach may be favored to minimize morbidity.

Keywords: Conductive hearing loss; Ectopic stapes; Empty oval window; High-resolution temporal bone CT; Ossicular malformation; Stapes malformation.

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Conflict of interest statement

Declarations. Conflicts of interests: The authors declare that they have no conflict of interest and no source of fundings.

References

    1. Bartel-Friedrich S, Wulke C (2007) Classification and diagnosis of ear malformations. GMS Curr Top Otorhinolaryngol Head Neck Surg 6:Doc05 - PubMed
    1. Teunissen EB, Cremers CWRJ (1993) Classification of congenital middle ear anomalies report on 144 ears. Ann Otol Rhinol Laryngol 102:606–612. https://doi.org/10.1177/000348949310200807 - DOI - PubMed
    1. Swartz JD, Faerber EN (1985) Congenital malformations of the external and middle ear: high-resolution CT findings of surgical import. AJR Am J Roentgenol 144:501–506. https://doi.org/10.2214/ajr.144.3.501 - DOI - PubMed
    1. Nomura Y, Nagao Y, Fukaya T (1988) Anomalies of the middle ear. Laryngoscope 98:390–393. https://doi.org/10.1288/00005537-198804000-00006 - DOI - PubMed
    1. Funasaka S (1979) Congenital ossicular anomalies without malformations of the external ear. Arch Otorhinolaryngol 224:231–240. https://doi.org/10.1007/BF01108781 - DOI - PubMed

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