Correlation Between High-Resolution Computed Tomography and Surgical Findings in Congenital Aural Atresia

Abstract

\s=b\ Congenital aural atresia poses a great challenge, even to a competent otologic surgeon, due to innumerable types of malformations affecting the conduction and perception of sound. Roentgenographic evaluation by plain roentgenography is inconclusive in most cases; polytomography is helping to some extent. Recent generations of high-resolution computed tomographic (CT) scanners are probably the best. Seven cases of unilateral and three cases of bilateral congenital aural atresia were evaluated with high-resolution CT. Subsequently, ten ears were operated on. Surgical findings were correlated with CT scan findings with respect to atresia plate, extent of pneumatization, ossicular anomalies, bony facial nerve canal, and inner ear.Use of CT scans bears considerable importance in the management of these types of cases. High-resolution CT scan, when targeted for maximal bony detail, is possibly the method of choice in congenital aural atresia when surgical correction is contemplated.

Facial Canal Anatomy in Patients with Microtia: Evaluation of the Temporal Bones with Thin-Section CT

“…The facial nerve has been reported to show abnormal lateral and anterior displacement in these patients (4,5,(7)(8)(9)15,16). However, few investigators report quantitative objective evidence indicating that in patients with congenital aural atresia, the facial nerve runs more laterally and anteriorly than that in control subjects (5,9).…”

“…Thus, it is essential to determine preoperatively the course of the facial nerve in these patients. The facial nerve has been reported to be more laterally and anteriorly displaced in these patients (4,5,(7)(8)(9)(10). However, there are few studies on the course of the facial nerve in patients with congenital aural atresia.…”

“…Thin-section computed tomography (CT) is the preferred technique for preoperative evaluation of aural atresia. There are several reports on the usefulness of thinsection CT for preoperative planning in patients with congenital aural atresia (3)(4)(5)(6).…”

Congenital Dysplasia of the Ear

“…Abnormalities of the vestibular system are the most common inner ear deformities encountered (figures 7,8,9).…”

“…In fact, the spectrum of malformation encompasses all stages of development; it is better to describe the abnormality in anatomic terms (involvment of the cochlea, the vestibule, the semicircular canals, and aqueducts) (figures 3,4,6,7,8,9).…”