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The Correlation Between Pre and Postoperative Hearing Level with High Resolution Computed Tomography (HRCT) Findings
A Asma1, A W Abdul Fatah2, A H Hamzaini3
1Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakub Latif, 56000 Cheras, Kuala Lumpur, Malaysia.
Insights
Preoperative high-resolution computed tomography (HRCT) scans and hearing assessments are crucial for congenital aural atresia (CAA). This study found no significant correlation between HRCT scores and hearing outcomes in CAA patients undergoing surgery.
Area of Science:
- Otolaryngology
- Medical Imaging
- Audiology
Background:
- Congenital aural atresia (CAA) management requires preoperative high-resolution computed tomography (HRCT) and hearing assessment.
- The Jahrsdoefer grading system, based on HRCT findings, aims to predict surgical success in CAA patients.
Purpose of the Study:
- To evaluate the correlation between preoperative and postoperative hearing levels with HRCT findings using the Jahrsdoefer grading system in CAA patients.
- To determine if the Jahrsdoefer score is a reliable predictor of hearing reconstruction outcomes.
Main Methods:
- Retrospective analysis of 32 ears with CAA from January 1997 to December 2007.
- Evaluation of demographic data, operative records, pre- and postoperative hearing levels (pure tone average air-bone gap or auditory brainstem response), and HRCT findings.
- Correlation analysis between HRCT scores and hearing levels using a 0.05 significance level.
Main Results:
- Three out of six ears that underwent canalplasty achieved successful hearing results (postoperative hearing level ≤ 30 dB).
- No significant correlation was found between preoperative hearing level and HRCT score (r = -0.292, P = 0.105).
- No significant correlation was found between postoperative hearing level and HRCT score (r = -0.127, P = 0.810).
Conclusions:
- Hearing evaluation and HRCT temporal bone imaging are independent assessments for CAA patients.
- The Jahrsdoefer grading system, based on HRCT, did not show a significant correlation with hearing outcomes in this cohort.
- Further research may be needed to refine predictive models for surgical success in congenital aural atresia.
Abstract:
In managing patient with congenital congenital aural atresia (CAA), preoperative high resolution computed tomography (HRCT) scan and hearing assessment are important. A grading system based on HRCT findings was first introduced by Jahrsdoefer in order to select appropriate candidates for operation and to predict the postoperative hearing outcome in CAA patients. The score of eight and more was considered as a good prognostic factor for hearing reconstruction surgery. However previously in our center this score was not used as the criteria for surgical procedure. This study was conducted at Center A to evaluate the correlation between pre and postoperative hearing level with HRCT based on a Jahrsdoefer grading system in patients with CAA. All records and HRCT films with CAA from January 1997 until December 2007 at Center A were evaluated. The demographic data, operative records, pre and post operative hearing levels and HRCT findings were analyzed. Hearing level in this study was based on a pure tone average of air-bone gap at 500 Hz, 1 kHz and 2 kHz or hearing level obtained from auditory brainstem response eudiometry. This study was approved by Research Ethics Committee (code number, FF-197-2008). Thirty-two ears were retrospectively evaluated. The postoperative hearing level of 30 dB and less was considered as successful hearing result postoperatively. Of the six ears which underwent canalplasty, three had achieved successful hearing result. However, there was no significant correlation between preoperative hearing level (HL) with HRCT score and postoperative HL with HRCT score at 0.05 significant levels (correlation coefficient = -0.292, P = 0.105 and correlation coefficient = -0.127, P = 0.810) respectively. Hearing evaluation and HRCT temporal bone are two independent evaluations for the patients with CAA before going for hearing reconstructive surgery.
