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Does preoperative hearing predict postoperative hearing in patients undergoing primary aural atresia repair?
Brian D Nicholas1, Kaelyn A Krook, Lincoln C Gray
1Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA 22908-0713, USA.
Objective:
The purpose of this study is to explore the correlation between preoperative hearing and early postoperative hearing results in patients undergoing primary aural atresia repair.
Study Design:
Retrospective review of 125 patients.
Setting:
Academic tertiary referral center.
Patients:
One hundred twenty-five patients (5-67 yr old) undergoing 133 primary aural atresia surgeries were included.
Main Outcome Measure(S):
Spearman correlation coefficients were calculated between preoperative and postoperative (mean, 7.5 wk; range, 3-40 wk after surgery) hearing outcome measures including 3-tone pure-tone average (PTA), speech reception threshold (SRT), speech discrimination scores (SDS), air-bone gap (ABG), change in ABG (ΔABG), and between preoperative SRT and Jahrsdoerfer score.
Results:
Preoperative PTA, SRT, SDS, and ABG correlated strongly with their respective postoperative values (correlation coefficients rho of 0.356 [p < 0.01], 0.199 [p < 0.05], 0.480 [p < 0.01], and 0.223 [p < 0.05], respectively). Preoperative PTA (0.407; p < 0.01), SRT (0.348; p < 0.01), SDS (-0.247; p < 0.01), and ABG (0.514; p < 0.01) also were correlated with ΔABG. When postoperative results were dichotomized to either normal (SRT, <30dB HL) or abnormal (SRT, ≥30dB HL), preoperative SRT was found to be a positive predictor of normal postoperative hearing (p = 0.05). Probability of normal postoperative hearing was 66% when preoperative SRT was 50 dB HL or lower and 40% when greater than 60 dB HL. Preoperative hearing (SRT) also trended toward a correlation with Jahrsdoerfer score (-0.168 [p = 0.058]).
Conclusion:
Among patients undergoing primary atresia repair, better preoperative hearing strongly predicts better postoperative hearing and correlates with ear anatomy. Preoperative hearing status should be factored when counseling atresia patients on hearing rehabilitation options.