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CT Evaluation of Congenital Aural Atresia: What the Radiologist and Surgeon Need to Know

Yeakley, Joel W.; Jahrsdoerfer, Robert A.

Journal of Computer Assisted Tomography: September-October 1996 - Volume 20 - Issue 5 - p 724-731

Purpose The preoperative evaluation of aural atresia and stenosis is strongly dependent upon high resolution CT. We have devised a 10 point surgical rating scale based on high resolution CT of the temporal bone that will provide radiologists with a stepwise method of evaluating these scans and will allow them to communicate these findings to otologic surgeons in a consistent fashion.

Method We prospectively evaluated 1,500 patients with aural atresia or stenosis for eight critical areas of temporal bone anatomy, each area receiving 1 rating scale point, with the exception of the presence of a stapes, which received 2 points. The appearance of the external ear received the final point on the rating scale since the external ear is formed earlier than the middle ear and helps to predict its deformities. The presurgical score was utilized in selecting surgical candidates and was correlated with the intraoperative findings as well as the postsurgical results by comparing pre- and postoperative speech reception threshold. Patients with a presurgical rating of ≤5 were not considered surgical candidates. Otherwise, the percentage of successful surgeries corresponded roughly to the rating scale.

Results and Conclusion Thus, a presurgical rating of 8 points translates into an 80% chance of resorting hearing to normal or near-normal levels.

From the Department of Radiology, University of Texas Houston Health Science Center, Houston, TX (J. W. Yeakley), and Department of Otolaryngology-Head and Neck Surgery, University of Virginia Medical Center, Charlottesville, VA (R. A. Jahrsdoerfer), U.S.A.

Address correspondence and reprint requests to Dr. J. W. Yeakley at Department of Radiology, University of Texas Houston Health Science Center, 6431 Fannin, 2.100 MSB, Houston, TX 77030, U.S.A.

© Lippincott-Raven Publishers.