[Expert consensus on a novel classification system, surgical management strategies, and prognostic evaluation for congenital ossicular chain malformations based on stapes footplate mobility and suprastructural integrity (2026 edition)].

Congenital ossicular chain malformation (COCM) is a congenital developmental disorder that impairs hearing function. It most commonly presents unilaterally, either as an isolated anomaly or in association with a variety of systemic syndromes; in severe cases, it may coexist with malformations of the auricle and external auditory canal. Owing to its insidious onset and the presence of an intact tympanic membrane, affected children are frequently misdiagnosed with secretory otitis media. Bilateral COCM, if left untreated in a timely manner, can hinder speech and cognitive development, while specific anatomical variants may elevate the risk of cholesteatoma formation. Diagnosis is predicated on the presence of persistent conductive hearing loss from early childhood, with preoperative high-resolution temporal bone CT scanning serving as a pivotal tool for anatomical evaluation. The management of COCM is primarily guided by patient and family preferences, with therapeutic options encompassing hearing aid fitting and surgical intervention. To standardize the diagnosis and treatment of COCM, optimize the selection of surgical strategies, and enhance clinical outcomes, domestic otology experts have jointly developed the "Expert consensus on a novel classification system, surgical management strategies, and prognostic evaluation for congenital ossicular chain malformations based on stapes footplate mobility and suprastructural integrity (2026 edition)". This consensus is grounded in the latest research evidence and accumulated clinical experience, systematically summarizing the epidemiology, pathogenesis, clinical manifestations, auxiliary examinations, treatment principles, and complications of non-syndromic COCM. Building upon existing classification systems, the consensus introduces a novel clinical classification framework centered on stapes footplate mobility and the integrity of suprastapes structures, which directly informs surgical decision-making. This new classification prioritizes guiding surgical strategy formulation and predicting postoperative outcomes, thereby providing a robust reference for the standardized diagnosis and clinical management of COCM.