Association Between Middle Ear Anomalies and the Severity of Mandibular Deformity in Hemifacial Microsomia

OBJECTIVES: Hemifacial microsomia (HFM) is frequently associated with middle ear anomalies. This study aimed to investigate the association between middle ear anomalies and the severity of mandibular deformity in patients with HFM. RESULTS: A total of 51 patients were included in this study. External ear deformities and malleus-incus complex abnormalities were prevalent across all HFM subtypes. Incus-stapes articulation differed significantly between type I and type II HFM, and between type I and type III HFM. Significant differences were observed in stapes morphology between type I and type III HFM, as well as between type II and type III HFM. Middle ear cavity development and mastoid pneumatization were significantly reduced in type III HFM compared with type I HFM. Inner ear anomalies were infrequently observed and were limited to a small subset of patients with severe HFM. Patients with more severe mandibular deformities demonstrated larger air-bone gaps and poorer air-conduction thresholds. CONCLUSION: In patients with HFM, the severity of mandibular deformity is significantly associated with middle ear structural abnormalities, including the ossicular chain, middle ear space, and mastoid pneumatization. Assessment of middle ear morphology may provide valuable adjunctive information for disease stratification, hearing outcome prediction, and surgical planning in HFM.