Grading System for the Selection of Patients With Congenital Aural Atresia

Jahrsdoerfer, Robert A.; Yeakley, Joel W.; Aguilar, Eugenio A.; Cole, Randolph R.; Gray, Lincoln

doi:10.1097/00129492-199201000-00004

Cited by 185 publications

(261 citation statements)

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“…Inclusion Criteria · Bilateral ear atresia or microtia with a Jahrsdoerfer score greater than 5 [12] . · Bilateral stable conductive or mixed hearing loss without bone conduction fluctuation over 15 dB HL in either direction during the past 2 years.…”

Section: Subject Selection Criteriamentioning

confidence: 99%

An Implantable Hearing System As Rehabilitation for Hearing Loss Due to Bilateral Aural Atresia: Surgical Technique and Audiological Results

Brito¹,

Ventura²,

Jorge³

et al. 2016

Int Adv Otol

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OBJECTIVE:To demonstrate the surgical technique and audiological results of a middle ear implant for restoring hearing in patients with bilateral aural atresia and microtia with conductive or mixed hearing loss. MATERIALS and METHODS:In this prospective study, 12 subjects aged 12 years and older presenting with hearing loss and bilateral congenital aural atresia underwent surgical insertion of a middle ear implant. The patients underwent tympanomastoidectomy with a wide opening of the attic and preservation of the roof of the atresic tympanic bone to expose the middle ear and position the floating mass transducer of the implant.RESULTS: There were no intraoperative or postoperative complications. The hearing threshold averages in a free field were 53.5 dB preoperatively and 25.6 dB postoperatively. Monosyllabic word recognition averaged 61% preoperatively and 91.3% postoperatively. The average speech perception in quiet conditions during the hearing in noise test improved from 67.11 dB to 45.99 dB, and the signal-to-noise ratio improved from 5.64 to 1.31. CONCLUSION:The tested system is an excellent option for auditory rehabilitation of conductive hearing loss due to bilateral ear atresia. The surgery is well structured and safe and provides several alternatives to the surgeon, which is valuable in difficult cases.

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Section: Subject Selection Criteriamentioning

confidence: 99%

An Implantable Hearing System As Rehabilitation for Hearing Loss Due to Bilateral Aural Atresia: Surgical Technique and Audiological Results

Brito¹,

Ventura²,

Jorge³

et al. 2016

Int Adv Otol

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show abstract

“…Malposition of the facial nerve has been reported in mild microtia in up to half of patients. 9 This is typically manifested by anterior displacement of the mastoid segment. Only 1 patient in this series had a mild anteriorly positioned mastoid segment.…”

Section: Discussionmentioning

confidence: 99%

“…More complex methods have been described, but a single axial and coronal measurement was determined adequate due to the availability of the contralateral normal ear for comparison. 8 HRCT of the temporal bone was evaluated for findings based on the criteria developed by Jahrsdoerfer et al 9 for identifying suitable candidates with congenital aural atresia for surgery. 10,11 The presence of ossicular anomalies, including fixation, abnormal position, and abnormal shape or size, was noted.…”

Section: Imaging Analysismentioning

confidence: 99%

High-Resolution CT Findings in Children with a Normal Pinna or Grade I Microtia and Unilateral Mild Stenosis of the External Auditory Canal

Jacob¹,

Gupta

Isaacson

et al. 2014

American Journal of Neuroradiology

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SUMMARY:A subset of patients presents with unilateral conductive hearing loss, a normal pinna or grade I microtia, and mild external auditory canal stenosis. The physical findings of microtia and a small external canal are commonly absent or subtle in this group of patients, who are being commonly referred for imaging to evaluate isolated conductive hearing loss. We present a case series of patients with unilateral conductive hearing loss and characteristic ossicular abnormalities, commonly anterior fixation of the malleus. All patients had a significantly increased distance from the cochlear promontory to the handle of the malleus and an abnormal incudostapedial angle, indicative of an abnormal ossicular position and/or morphology. Successful surgical reconstruction of the ossicular chain was attempted and accomplished in 3 patients. ABBREVIATIONS:CHL ϭ conductive hearing loss; EAC ϭ external auditory canal; HRCT ϭ high-resolution CT

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“…The informed consent was obtained from all participants. All 18 patients who were included in this series had complete congenital aural atresia and a Jahrsdoerfer [7] grade of 6 or more. Table 1 shows the age at atresiaplasty surgery, sex, laterality of aural atresia, Jahrsdoerfer atresia grading, follow-up periods, and complications for the 18 atresiaplasty patients (19 ears).…”

Section: Methodsmentioning

confidence: 99%

A New Flap Technique for Reconstruction of Microtia and Congenital Aural Atresia

Chen

Jiang

et al. 2015

Indian J Surg

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Atresiaplasty is still a challenge for otolaryngologist, although the operation technique has been modified several times over the past decades. This study describes a reliable flap technique for combining atresiaplasty with total auricular reconstruction by performing the total auricular reconstruction with the MEDPOR framework at the same time as the atresiaplasty for patients with microtia and congenital aural atresia. We performed a prospective study of the medical records of 18 consecutive patients with congenital aural atresia. All the patients had a Jahrsdoerfer grade of 6 or higher, and the mean age was 9.7 years. Atresiaplasty with the new flap technique was performed in 19 ears in our department from January 1, 2011, through July 31, 2013. Among the postoperative ears, 17 ears (89.5 %) had the excellent outcomes, without infections and stenosis. Only two ears (10.5 %) had postoperative stenosis and atresia after infection, respectively. There were no other complications. We concluded that the new flap technique combining atresiaplasty and total auricular reconstruction yielded satisfactory canal patency, low infection rates, and favorable cosmetic results, with acceptable rates of complications. This novel flap technique is a valuable option in the armamentarium of microtia and atresia surgeons.

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Grading System for the Selection of Patients With Congenital Aural Atresia

Cited by 185 publications

References 0 publications

An Implantable Hearing System As Rehabilitation for Hearing Loss Due to Bilateral Aural Atresia: Surgical Technique and Audiological Results

An Implantable Hearing System As Rehabilitation for Hearing Loss Due to Bilateral Aural Atresia: Surgical Technique and Audiological Results

High-Resolution CT Findings in Children with a Normal Pinna or Grade I Microtia and Unilateral Mild Stenosis of the External Auditory Canal

A New Flap Technique for Reconstruction of Microtia and Congenital Aural Atresia

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