Favorable Prognostic Factors for Long-term Postoperative Hearing Results After Canal Tympanoplasty for Congenital Aural Stenosis

Sakamoto, Takashi; Kikkawa, Yuichiro; Kikuta, Seishi; Kinoshita, Makoto; Ueha, Rumi; Suzukawa, Keigo; Kashio, Akinori; Kakigi, Akinobu; Ito, Ken; Suzuki, Michitaka; Yamasoba, Tatsuya

doi:10.1097/mao.0000000000000335

“…Our similar results between syndromic and nonsyndromic cases correlate with a prior study from Sakamoto and colleagues. 17 In a prior series, no significant differences in audiologic outcomes were found between cases in which an OCR was performed compared with cases in which an intact and mobile ossicular chain was encountered. 10 In the current larger series, statistically significant differences between these 2 groups were found in 4 of the 6 audiometric parameters assessed.…”

Section: Discussionmentioning

confidence: 87%

Surgical and Audiometric Outcomes for Repair of Congenital Aural Atresia and Hypoplasia

Moss

¹

,

Lin

²

,

Cueva³

2016

JAMA Otolaryngol Head Neck Surg

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“…Previous studies analysing the clinical features of CAS involved small sample sizes, and no studies focused on the stability of the hearing outcomes567. This study uses the largest sample of CAS, providing guidance in consultation and emphasizing important aspects for long-term follow-up.…”

mentioning

confidence: 99%

“…Patients with stenosis sizes of 2 mm or less are at high risk for developing cholesteatoma and should undergo surgery; however, the data in the present study challenged this viewpoint. To date, there are no large sample studies focusing on the clinical features and long-term outcomes of CAS, and no studies have described the important parameter of measuring the diameter of EAC 5 6 7 8 9 10 11 .…”

mentioning

confidence: 99%

Congenital Aural Stenosis: Clinical Features and Long-term Outcomes

Li

¹

,

Ying

²

,

Chen

³

et al. 2016

Sci Rep

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The aim of the present study was to comprehensively evaluate the clinical features and long-term outcomes of congenital aural stenosis (CAS). This study presents a retrospective review of patients who underwent meatoplasty for CAS at a tertiary referral hospital from 2008 to 2015. A total of 246 meatoplasty procedures were performed on 232 patients in the present study. We performed multivariate regression analysis. Except in the age < 6 years group, no significant difference was observed among different age groups for cholesteatoma formation, p > 0.05. Except for the stenosis of the external auditory canal (EAC) (>4 mm) group, the other stenosis of EAC groups were not associated with cholesteatoma formation, p > 0.05. Postoperative air-bone gaps (ABG) less than 30 dB occurred in 77.3% (99/128) of the patients, and the Jahrsdoerfer score was associated with postoperative ABG, p < 0.001. The complication rate of CAS was 13.8% (20/144), and males showed a higher risk for postoperative complications (OR, 6.563; 95% CI, 1.268–33.966, p = 0.025). These results indicate that meatoplasty was an effective surgical intervention for CAS, showing a stable hearing outcome with prolonged follow-up. There was no significant difference between the cholesteatoma and no cholesteatoma groups for hearing outcomes, p > 0.05.

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“…Thus, there was no significant difference in the same surgical technique between the cholesteatoma and no cholesteatoma groups, including Δ ABG, preoperative and postoperative ABG 20 . A previous study suggested that the Jahrsdoerfer score (modified) was less useful in terms of predicting long-term hearing prognosis after canal tympanoplasty for CAS in 25 patients 6 . Nevertheless, the mean Jahrsdoerfer score in the no cholesteatoma group was higher than that in the cholesteatoma group, and the Jahrsdoerfer score is a factor that affects postoperative ABG.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with stenosis sizes of 2 mm or less are at high risk for developing cholesteatoma and should undergo surgery; however, the data in the present study challenged this viewpoint. To date, there are no large sample studies focusing on the clinical features and long-term outcomes of CAS, and no studies have described the important parameter of measuring the diameter of EAC [5][6][7][8][9][10][11] . The aim of the present study was to comprehensively evaluate the clinical features and long-term outcomes of CAS, and challenge the previous viewpoint.…”

mentioning

confidence: 99%

Congenital Aural Stenosis: Clinical Features and Long-term Outcomes

Li

¹

,

Chen

²

,

Chen

³

et al. 2016

J. Laryngol. Otol.

0

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The aim of the present study was to comprehensively evaluate the clinical features and long-term outcomes of congenital aural stenosis (CAS). This study presents a retrospective review of patients who underwent meatoplasty for CAS at a tertiary referral hospital from 2008 to 2015. A total of 246 meatoplasty procedures were performed on 232 patients in the present study. We performed multivariate regression analysis. Except in the age < 6 years group, no significant difference was observed among different age groups for cholesteatoma formation, p > 0.05. Except for the stenosis of the external auditory canal (EAC) (>4 mm) group, the other stenosis of EAC groups were not associated with cholesteatoma formation, p > 0.05. Postoperative air-bone gaps (ABG) less than 30 dB occurred in 77.3% (99/128) of the patients, and the Jahrsdoerfer score was associated with postoperative ABG, p < 0.001. The complication rate of CAS was 13.8% (20/144), and males showed a higher risk for postoperative complications (OR, 6.563; 95% CI, 1.268-33.966, p = 0.025). These results indicate that meatoplasty was an effective surgical intervention for CAS, showing a stable hearing outcome with prolonged follow-up. There was no significant difference between the cholesteatoma and no cholesteatoma groups for hearing outcomes, p > 0.05.Congenital aural stenosis (CAS) carries a much greater risk of cholesteatoma compared with congenital aural atresia (CAA). Cole and Jahrsdoerfer defined CAS as an external auditory canal (EAC) with a diameter of 4 mm or less that frequently occurs in conjunction with grade 1 and grade 2 microtia. This diameter was selected because none of the patients with canal openings larger than 4 mm developed cholesteatoma 1,2 . The diagnosis of CAS is based on clinical examination (anamnesis, physical and audiometric evaluation) and imaging, particularly high-resolution computed tomography (HRCT) of the temporal bones 3 . The treatment of EAC cholesteatoma depends on the extent of the disease. Small lesions can typically be controlled with regular debridement, combined with the administration of topical antibiotics, while large and destructive lesions require surgery 4 . The data on patients with CAS are limited, and the fundamental knowledge of CAS is still based on Cole and Jahrsdoerfer (1990). Two important parameters to consider when managing with CAS are patient age and stenosis size 1 . Patients with stenosis sizes of 2 mm or less are at high risk for developing cholesteatoma and should undergo surgery; however, the data in the present study challenged this viewpoint. To date, there are no large sample studies focusing on the clinical features and long-term outcomes of CAS, and no studies have described the important parameter of measuring the diameter of EAC [5][6][7][8][9][10][11] . The aim of the present study was to comprehensively evaluate the clinical features and long-term outcomes of CAS, and challenge the previous viewpoint. Previous studies analysing the clinical features of CAS involved small sample sizes,...

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Favorable Prognostic Factors for Long-term Postoperative Hearing Results After Canal Tympanoplasty for Congenital Aural Stenosis

Abstract: The absence of EAC cholesteatoma and anterolateral position of the malleus/incus complex with respect to the stapes are considered useful in predicting long-term favorable hearing results after canal tympanoplasty for CAS.

Cited by 10 publications

References 18 publications

Surgical and Audiometric Outcomes for Repair of Congenital Aural Atresia and Hypoplasia

Surgical and Audiometric Outcomes for Repair of Congenital Aural Atresia and Hypoplasia

Congenital Aural Stenosis: Clinical Features and Long-term Outcomes

Congenital Aural Stenosis: Clinical Features and Long-term Outcomes

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