Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-19T10:29:31.629Z Has data issue: false hasContentIssue false
  • English
  • Français

High-resolution computed tomography evaluation of congenital aural atresia – how useful is this?

Published online by Cambridge University Press:  20 July 2020

R Gautam ,
J Kumar ,
G S Pradhan ,
J C Passey ,
R Meher  and
A Mehndiratta
R Gautam
Affiliation:
Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’), and Guru Nanak Eye Centre (‘GNEC’) Hospitals, New Delhi, Delhi, India
J Kumar*
Affiliation:
Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’), and Guru Nanak Eye Centre (‘GNEC’) Hospitals, New Delhi, Delhi, India
G S Pradhan
Affiliation:
Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’), and Guru Nanak Eye Centre (‘GNEC’) Hospitals, New Delhi, Delhi, India
J C Passey
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’), and Guru Nanak Eye Centre (‘GNEC’) Hospitals, New Delhi, Delhi, India
R Meher
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College and Associated Lok Nayak, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’), and Guru Nanak Eye Centre (‘GNEC’) Hospitals, New Delhi, Delhi, India
A Mehndiratta
Affiliation:
Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (‘GIPMER’), and Guru Nanak Eye Centre (‘GNEC’) Hospitals, New Delhi, Delhi, India
*
Author for correspondence: Dr Jyoti Kumar, Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, GIPMER and GNEC Hospitals, New Delhi, Delhi-110002, India E-mail: drjyotikumar@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To depict various temporal bone abnormalities on high-resolution computed tomography in congenital aural atresia patients, and correlate these findings with auditory function test results and microtia subgroup.

Methods

Forty patients (56 ears) with congenital malformation of the auricle and/or external auditory canal were evaluated. Auricles were graded according to Marx's classification, divided into subgroups of minor (grades I and II) and major (III and IV) microtia. Other associated anomalies of the external auditory canal, tympanic cavity, ossicular status, oval and round windows, facial nerve, and inner ear were evaluated.

Results

Minor and major microtia were observed in 53.6 and 46.4 per cent of ears respectively. Mean hearing levels were 62.47 and 62.37 dB respectively (p = 0.98). The malleus was the most commonly dysplastic ossicle (73.3 vs 80.8 per cent of ears respectively, p = 0.53). Facial nerve (mastoid segment) abnormalities were associated (p = 0.04) with microtia subgroup (80 vs 100 per cent in minor vs major subgroups).

Conclusion

Microtia grade was not significantly associated with mean hearing levels or other ear malformations, except for external auditory canal and facial nerve (mastoid segment) anomalies. High-resolution computed tomography is essential in congenital aural atresia, before management strategy is decided.

Keywords

MicrotiaTemporal BoneFacial NerveMiddle Ear
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 7 , July 2020 , pp. 610 - 622
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr J Kumar takes responsibility for the integrity of the content of the paper

References

De la Cruz, A, Teufert, K. Congenital malformation of the external auditory canal and middle ear. In: Brackmann, D, Shelton, C, Arriaga, M, eds. Otologic Surgery, 3rd edn. Philadelphia: Saunders, 2010;55–72CrossRefGoogle Scholar
Qin, FH, Zhang, TY, Dai, P, Yang, L. Anatomic variants on computed tomography in congenital aural atresia and stenosis. Clin Exp Otorhinolaryngol 2015;8:320–8CrossRefGoogle ScholarPubMed
Luquetti, DV, Heike, CL, Hing, AV, Cunningham, ML, Cox, TC. Microtia: epidemiology and genetics. Am J Med Genet A 2012;158A:124–39CrossRefGoogle ScholarPubMed
Kelley, PE, Scholes, MA. Microtia and congenital aural atresia. Otolaryngol Clin North Am 2007;40:61–80CrossRefGoogle ScholarPubMed
Ishimoto, SI, Ito, K, Karino, S, Takegoshi, H, Kaga, K, Yamasoba, T. Hearing levels in patients with microtia: correlation with temporal bone malformation. Laryngoscope 2007;117:461–5CrossRefGoogle ScholarPubMed
Gao, R, Wang, Y, Fan, Y, Ai, X, Zhang, X, Xue, H et al. The role of HRCT and three dimensional VR CT findings in patients of congenital atresia combined with microtia. Int J Pediatr Otorhinolaryngol 2012;76:1779–84CrossRefGoogle ScholarPubMed
Schuknecht, HF. Congenital aural atresia. Laryngoscope 1989;99:908–17CrossRefGoogle ScholarPubMed
Marx, H. Ear deformities. In: Henke, F, Lubarsh, D, eds. Handbook of Special Pathological Anatomy and Histology [in German]. Berlin: Springer, 1926;620–5Google Scholar
Rogers, B. Anatomy, embryology, and classification of auricular deformities. In: Tanzer, R, Edgerton, M, eds. Symposium on Reconstruction of the Auricle, Vol. 10. St Louis: CV Mosby, 1974;3–11Google Scholar
Jahrsdoerfer, RA, Yeakley, JW, Aquilar, EA, Cole, RR, Gray, LC. Grading system for the selection of patients with congenital aural atresia. Am J Otol 1992;13:6–12Google ScholarPubMed
Carfrae, MJ, Jahrsdoerfer, RA, Kesser, BW. Malleus bar: an unusual ossicular abnormality in the setting of congenital aural atresia. Otol Neurotol 2010;31:415–18CrossRefGoogle ScholarPubMed
Mukherjee, S, Kesser, BW, Raghavan, P. The “boomerang” malleus-incus complex in congenital aural atresia. AJNR Am J Neuroradiol 2014;35:2181–5CrossRefGoogle ScholarPubMed
Tasar, M, Yetiser, S, Yildirim, D, Bozlar, U, Tasar, MA, Saglam, M et al. Preoperative evaluation of the congenital aural atresia on computed tomography; an analysis of the severity of the deformity of the middle ear and mastoid. Eur J Radiol 2007;62:97–105CrossRefGoogle ScholarPubMed
Jacob, R, Gupta, S, Isaacson, B, Kutz, JW, Roland, P, Xi, Y et al. High-resolution CT findings in children with a normal pinna or grade I microtia and unilateral mild stenosis of the external auditory canal. AJNR Am J Neuroradiol 2015;36:17680CrossRefGoogle ScholarPubMed
Takegoshi, H, Kaga, K, Kikuchi, S, Ito, K. Mandibulofacial dysostosis: CT evaluation of the temporal bones for surgical risk assessment in patients of bilateral aural atresia. Int J Pediatr Otorhinolaryngol 2000;54:33–40CrossRefGoogle ScholarPubMed
Swartz, JD, Faerber, EN. Congenital malformations of the external and middle ear: high-resolution CT findings of surgical import. AJR Am J Roentgenol 1985;144:501–6CrossRefGoogle ScholarPubMed
Cole, RR, Jahrsdoerfer, RA. The risk of cholesteatoma in congenital aural stenosis. Laryngoscope 1990;100:576–8CrossRefGoogle ScholarPubMed
Casale, G, Nicholas, BD, Kesser, BW. Acquired ear canal cholesteatoma in congenital aural atresia/stenosis. Otol Neurotol 2014;35:1474–9CrossRefGoogle ScholarPubMed
Patil, AR, Bhalla, A, Gupta, P, Goyal, D, Vishnubhatla, S, Ramavat, A et al. HRCT evaluation of microtia: a retrospective study. Indian J Radiol Imaging 2012;22:188–94Google ScholarPubMed
Mayer, TE, Brueckmann, H, Siegert, R, Witt, A, Weerda, H. High-resolution CT of the temporal bone in dysplasia of the auricle and external auditory canal. AJNR Am J Neuroradiol 1997;18:53–65Google ScholarPubMed
Dedhia, K, Yellon, RF, Branstetter, BF, Egloff, AM. Anatomic variants on computed tomography in congenital aural atresia. Otolaryngol Head Neck Surg 2012;147:323–8CrossRefGoogle ScholarPubMed
Booth, TN, Vezina, LG, Karcher, G, Dubovsky, EC. Imaging and clinical evaluation of isolated atresia of the oval window. AJNR Am J Neuroradiol 2000;21:171–4Google ScholarPubMed
Tekes, A, Ishman, SL, Baugher, KM, Brown, DJ, Lin, SY, Tunkel, DE et al. Does microtia predict severity of temporal bone CT abnormalities in children with persistent conductive hearing loss? J Neuroradiol 2013;40:192–7CrossRefGoogle ScholarPubMed
Vrabec, JT, Lin, JW. Inner ear anomalies in congenital aural atresia. Otol Neurotol 2010;31:1421–6CrossRefGoogle ScholarPubMed