Semiautomated Middle Ear Volume Measurement as a Predictor of Postsurgical Outcomes for Congenital Aural Atresia

Kabadi, Sushila; Ruhl, Douglas S.; Mukherjee, Sugoto; Kesser, Bradley W.

doi:10.3174/ajnr.a5475

Cited by 13 publications

(6 citation statements)

References 14 publications

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“…An overview of the search process can be found in Figure 1. Descriptive features of articles about atresia surgery can be found in Supplemental Content 2, http://links.lww.com/MAO/B684 (9,10,18–52), and descriptive features of articles about implantable devices can be found in Supplemental Content 3, http://links.lww.com/MAO/B685 (8,10,22,43,47,48,53–99). All articles selected for inclusion were at least level 4 based on Oxford Level of Evidence.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis

et al. 2023

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Objective To compare audiometric outcomes, complications, and revisions required for implantable bone-conduction devices (BCDs) versus atresia surgery for the treatment of hearing loss associated with congenital aural atresia. Databases Reviewed PubMed, Scopus, CINAHL. Methods Databases were searched for English articles from inception to July 1, 2022, for studies reporting audiometric outcomes or complications for either BCDs or atresia surgery for the treatment of congenital aural atresia. Main outcome measures included pure-tone audiometry, air-bone gap, speech reception threshold, associated complications, and rates of revision for each treatment option. Results We identified 973 abstracts, of which 89 were selected for data extraction and analysis. A total of 2,611 patients were included, 1,901 in the atresia surgery group and 710 in the BCDs group. A meta-analysis of single means was conducted for age and audiometric outcomes, and a meta-analysis of proportions was conducted for complications and revisions. The average short-term improvement in pure-tone audiometry for the BCDs group was 34.4 ± 1.6 dB compared with 22.4 ± 1.5 dB for the atresia surgery group, representing a significant difference (12.0 dB; 95% confidence interval, 11.9–12.2; p < 0.0001). A smaller proportion of complications were reported in the devices group (16.9%) compared with the atresia surgery group (45.7%). In addition, a smaller proportion of cases in the devices group required some degree of revision (17.8%) compared with the atresia surgery group (23.0%). Conclusions This study demonstrates that implantable BCDs have significantly better audiometric outcomes as well as a lower rate of complications and revisions required compared with atresia surgery.

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Section: Resultsmentioning

confidence: 99%

Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis

et al. 2023

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“…Studies show middle ear volume correlates with hearing outcomes: the larger the middle ear volume, the better the postoperative hearing (14,15). Although we did not perform a middle ear volumetric comparison between the younger and older age groups, middle ear volume is close to adult size at birth (16), so volume of middle ear space should not play a role in any difference in outcomes between older and younger patients undergoing CAA repair.…”

Section: Discussionmentioning

confidence: 99%

Audiometric Outcomes After Surgical Repair of Congenital Aural Atresia: Does Age Matter?

Jonas

Casazza²,

Kesser

2022

Otol Neurotol

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Objective: To determine if there is an age-based difference in audiometric outcomes for patients undergoing primary congenital aural atresia (CAA) repair. Study Design: Retrospective chart review. Setting: Single academic, high-volume, tertiary care hospital. Patients: Individuals undergoing primary CAA repair by a single surgeon between 2004 and 2020. Intervention(s): CAA repair. Main Outcome Measure(s): Preoperative and postoperative four tone (500, 1,000, 2,000, 4,000 Hz) air-conduction pure-tone average (PTA), bone-conduction PTA, air-bone gap and speech reception threshold, and preoperative to postoperative change in values. Results: We identified 247 patients (262 ears) who underwent repair. The mean and median ages were approximately 12 and 8.5 years, respectively, both of which served as cutoff ages to compare younger versus older patients. The average preoperative to postoperative improvement values in air-conduction PTA, air-bone gap, and speech reception threshold for individuals younger than 12 years were 26.6 ± 10.2, 23.8 ± 12.6, and 30.1 ± 12.1 dB hearing level (HL), respectively, and those for individuals 12 years or older were 25.9 ± 15.7, 26.2 ± 10.3, and 31.3 ± 12.8 dB HL, respectively. For individuals younger than 8.5 years, the values were 25.8 ± 9.5, 24.9 ± 9.4, and 30.0 ± 10.6 dB HL, respectively, and those for individuals 8.5 years or older were 27.1 ± 13.5, 25.7 ± 11.0, and 30.0 ± 14.6 dB HL, respectively. The improvement did not differ significantly between the younger and older groups, using both cutoff ages. There was no difference in revision surgery rates or complications between groups. Conclusion: An individual at any age can enjoy audiometric improvement from atresia repair.

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“…This provides for a direct measurement of middle ear volume rather than the indirect measurement provided by tympanometry. This computer‐assisted, semiautomated calculation of middle ear volume has been used in prior research to show that in the setting of aural atresia, patients with large atretic middle ear volumes had better post‐operative outcomes with respect to pure tone average and speech reception thresholds than those with small atretic middle ear volumes . An interesting follow‐up study would be to correlate success rates of surgical tympanoplasty with MMEV—do larger MMEVs correlate with higher success rates of closure of TM perforations?…”

Section: Discussionmentioning

confidence: 99%

Correlation between hearing loss and middle ear volume in patients with a tympanic membrane perforation

2019

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Objective To investigate a possible correlation between the degree of conductive hearing loss (CHL) caused by an isolated tympanic membrane (TM) perforation and mastoid‐middle ear volume. Study Design Retrospective chart, audiometry, and computed tomography (CT) imaging review. Methods Adult patients with a diagnosis of isolated TM perforation between 2010 and 2018 were identified and their audiometric data collected. Mastoid‐middle ear volume (MMEV) was then calculated based on segmentation analysis from the patient's head or temporal bone CT. Calculated MMEV was compared to MMEV derived by tympanometry. A Student's t‐test was performed to determine a correlation between the calculated MMEV on CT imaging and the degree of conductive hearing loss as measured by the air bone gap on standard audiometry. Results There was a statistically significant difference between MMEV as determined by segmentation analysis compared to that determined by tympanometry (absolute average percent difference = 33.8%; range ‐49.5% to +155.2%; P = .03). Greater MMEV determined by segmentation analysis correlated with smaller air bone gap; this trend approached but did not reach statistical significance (P = .09). Conclusions Calculated MMEV by segmentation analysis on CT imaging may be a more accurate estimate of MMEV than tympanometry. MMEV may be correlated to the degree of conductive hearing loss in the setting of isolated TM perforation where greater volume was associated with better hearing. Level of Evidence 4 Laryngoscope, 130:E228–E232, 2020

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Semiautomated Middle Ear Volume Measurement as a Predictor of Postsurgical Outcomes for Congenital Aural Atresia

Abstract: Middle ear volume, calculated in a semiautomated fashion, is predictive of postsurgical audiometric outcomes, both independently and in combination with the conventional J-score.

Cited by 13 publications

References 14 publications

Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis

Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis

Audiometric Outcomes After Surgical Repair of Congenital Aural Atresia: Does Age Matter?

Correlation between hearing loss and middle ear volume in patients with a tympanic membrane perforation

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