Favorable prognostic factors for long-term postoperative hearing results after canal tympanoplasty for congenital aural stenosis

Otol Neurotol. 2014 Jul;35(6):966-71. doi: 10.1097/MAO.0000000000000335.

Abstract

Objective: We aimed to determine favorable prognostic factors for long-term postoperative hearing results after canal tympanoplasty for congenital aural stenosis (CAS).

Study design: Retrospective case review.

Setting: Tertiary referral center.

Patients: Canal tympanoplasty for CAS was performed in 25 ears.

Intervention: Primary repair of CAS.

Main outcome measures: The influences of the following factors on the success of surgery were assessed by univariate and multivariate logistic regression analyses: modified Jahrsdoerfer grading system total score; age at surgery; patterns of presentation (whether sporadic or syndromic); presence of external auditory canal (EAC) cholesteatoma; presence of ossicular fixation, including the malleus bar; presence of a partial atretic plate; exposure of the facial nerve at the tympanic portion; type of tympanoplasty; and each component of the modified Jahrsdoerfer grading system.

Results: The univariate analysis revealed that the absence of EAC cholesteatoma (p = 0.029) and the presence of a partial atretic plate (p = 0.040) were significant predictive factors for favorable hearing prognosis, whereas the multivariate logistic regression analysis showed that an absence of EAC cholesteatoma was the most significant favorable predictive factor (p = 0.011), followed by anterolateral position of the malleus/incus complex with respect to the stapes as the second-most favorable factor (p = 0.021).

Conclusion: 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.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Congenital Abnormalities / pathology
  • Congenital Abnormalities / surgery*
  • Constriction, Pathologic / surgery
  • Ear / abnormalities*
  • Ear / pathology
  • Ear / surgery
  • Ear Canal / abnormalities
  • Ear Canal / surgery*
  • Female
  • Hearing*
  • Humans
  • Incus / surgery
  • Logistic Models
  • Male
  • Malleus / surgery
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Tympanic Membrane / abnormalities
  • Tympanic Membrane / surgery*
  • Tympanoplasty / methods*
  • Young Adult

Supplementary concepts

  • Aural Atresia, Congenital