Skip to main content
Log in

Prognostic factors for long-term hearing preservation after canal-tympanoplasty for congenital aural atresia

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The present study aimed to determine favorable prognostic factors for long-term postoperative hearing outcome after canal-tympanoplasty for congenital aural atresia (CAA). We retrospectively reviewed pre and postoperative hearing results and image findings of 51 ears with CAA performed by canal-tympanoplasty for primary repair. Averages of the postoperative air and bone-conduction thresholds, and the air–bone gap (ABG) were calculated from the last pure-tone audiometry. Follow-up duration ranged from 16 to 139 months. A successful hearing result was defined as a postoperative ABG of ≤15 dB, or a postoperative pure-tone average of ≤30 dB. The influence of the following factors on the success of surgery was assessed by multivariate logistic regression analysis: total Jahrsdoerfer grading system score, age at surgery, and dimensions of middle ear including incudostapedial joint angulation, mesotympanic height, mesotympanic width, mesotympanic depth, mesotympanic area, mesotympanic volume, reconstructable external auditory canal (EAC) diameter, and reconstructable EAC height. Successful hearing outcomes were achieved in 24 of 51 ears (47.1 %). A multivariate logistic regression analysis showed that an EAC area >72.3 mm2 was the most significant favorable predictive factor (P = 0.006), followed by mesotympanic depth >5.5 mm (P = 0.013), mesotympanic height >4.6 mm (P = 0.016), and EAC diameter >9.5 mm (P = 0.029). In conclusion, the size of the reconstructable EAC and mesotympanum is important for predicting long-term favorable hearing outcome following canal-tympanoplasty for CAA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. De la Cruz A, Teufert KB (2003) Congenital aural atresia surgery: long-term results. Otolaryngol Head Neck Surg 129(1):121–127

    Article  PubMed  Google Scholar 

  2. Ishimoto S et al (2007) Hearing levels in patients with microtia: correlation with temporal bone malformation. Laryngoscope 117(3):461–465

    Article  PubMed  Google Scholar 

  3. Dedhia K et al (2012) Anatomic variants on computed tomography in congenital aural atresia. Otolaryngol Head Neck Surg 147(2):323–328

    Article  PubMed  Google Scholar 

  4. Ishimoto S et al (2004) The role of the external auditory canal in the development of the malleal manubrium in humans. Arch Otolaryngol Head Neck Surg 130(8):913–916

    Article  PubMed  Google Scholar 

  5. Ishimoto S et al (2005) Correlation between microtia and temporal bone malformation evaluated using grading systems. Arch Otolaryngol Head Neck Surg 131(4):326–329

    Article  PubMed  Google Scholar 

  6. Yeakley JW, Jahrsdoerfer RA (1996) CT evaluation of congenital aural atresia: what the radiologist and surgeon need to know. J Comput Assist Tomogr 20(5):724–731

    Article  CAS  PubMed  Google Scholar 

  7. Yellon RF, Branstetter BF (2010) Prospective blinded study of computed tomography in congenital aural atresia. Int J Pediatr Otorhinolaryngol 74(11):1286–1291

    Article  PubMed  Google Scholar 

  8. Yu Z et al (2008) Facial nerve course in congenital aural atresia––identified by preoperative CT scanning and surgical findings. Acta Otolaryngol 128(12):1375–1380

    Article  PubMed  Google Scholar 

  9. Chandrasekhar SS, De la Cruz A, Garrido E (1995) Surgery of congenital aural atresia. Am J Otol 16(6):713–717

    CAS  PubMed  Google Scholar 

  10. Chang SO et al (2002) Prevention of postoperative meatal stenosis with anteriorly and inferiorly based periosteal flaps in congenital aural atresia surgery. Otol Neurotol 23(1):25–28

    Article  CAS  PubMed  Google Scholar 

  11. Digoy GP, Cueva RA (2007) Congenital aural atresia: review of short- and long-term surgical results. Otol Neurotol 28(1):54–60

    Article  PubMed  Google Scholar 

  12. El-Hoshy Z, Abdel-Aziz M, Shabana M (2008) Congenital aural atresia: transmastoid approach; an old technique with good results. Int J Pediatr Otorhinolaryngol 72(7):1047–1052

    Article  PubMed  Google Scholar 

  13. Lambert PR (1998) Congenital aural atresia: stability of surgical results. Laryngoscope 108(12):1801–1805

    Article  CAS  PubMed  Google Scholar 

  14. Nishizaki K, Masuda Y, Karita K (1999) Surgical management and its post-operative complications in congenital aural atresia. Acta Otolaryngol Suppl 540:42–44

    Article  CAS  PubMed  Google Scholar 

  15. Teufert KB, De la Cruz A (2004) Advances in congenital aural atresia surgery: effects on outcome. Otolaryngol Head Neck Surg 131(3):263–270

    Article  PubMed  Google Scholar 

  16. Chang SO, Choi BY, Hur DG (2006) Analysis of the long-term hearing results after the surgical repair of aural atresia. Laryngoscope 116(10):1835–1841

    Article  PubMed  Google Scholar 

  17. Oliver ER et al (2010) Middle ear dimensions in congenital aural atresia and hearing outcomes after atresiaplasty. Otol Neurotol 31(6):946–953

    Article  PubMed  Google Scholar 

  18. Kim DW et al (2011) Continuity of the incudostapedial joint: a novel prognostic factor in postoperative hearing outcomes in congenital aural atresia. Acta Otolaryngol 131(7):701–707

    Article  PubMed  Google Scholar 

  19. Mishiro Y et al (2009) Prognostic factors for short-term outcomes after ossiculoplasty using multivariate analysis with logistic regression. Arch Otolaryngol Head Neck Surg 135(8):738–741

    Article  PubMed  Google Scholar 

  20. Mishiro Y et al (2010) Prognostic factors of long-term outcomes after ossiculoplasty using multivariate analysis. Eur Arch Otorhinolaryngol 267(6):861–865

    Article  PubMed  Google Scholar 

  21. Yeakley JW et al (1992) Grading system for the selection of patients with congenital aural atresia. Am J Otol 13(1):6–12

    PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no conflict of interest to declare.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Takashi Sakamoto.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sakamoto, T., Kikuta, S., Kikkawa, Y.S. et al. Prognostic factors for long-term hearing preservation after canal-tympanoplasty for congenital aural atresia. Eur Arch Otorhinolaryngol 272, 3151–3156 (2015). https://doi.org/10.1007/s00405-014-3164-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-014-3164-6

Keywords

Navigation