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Association between Ear Position in Microtia and Middle Ear Development in 3-Dimensional Computed Tomography Imaging
Takashi Kurabayashi1, Hirotaka Asato1, Kimitaka Kaga2
1From the Department of Plastic and Reconstructive Surgery, Dokkyo Medical University.
Plastic and Reconstructive Surgery
|November 11, 2025
Summary
The vertical position of the auricular concavity, a simple external landmark, strongly correlates with middle ear development in microtia patients. This finding aids in predicting surgical candidacy for hearing improvement.
Area of Science:
- Otolaryngology
- Plastic Surgery
- Medical Imaging
Background:
- A known link exists between microtia (ear deformity) and middle ear development.
- However, some patients with severe microtia have well-developed middle ears, suggesting other factors are involved.
Purpose of the Study:
- To investigate the relationship between external auricular anatomical features and middle ear development in microtia.
- To identify a simple clinical predictor for middle ear development.
Main Methods:
- 3D CT scans of 221 auricles from 188 microtia patients were analyzed.
- Auricles were classified based on the position of the "Auricular Concavity" relative to the zygion (upper vs. lower).
- Jahrsdoerfer scores were compared between the two groups.
Main Results:
- The upper auricular concavity group showed significantly higher mean Jahrsdoerfer scores (8.1) compared to the lower group (4.2).
- This indicates a strong association between the auricle's vertical position and middle ear development.
Conclusions:
- The vertical position of the auricular concavity is a significant predictor of middle ear development in microtia.
- This simple, non-imaging assessment can help identify patients suitable for middle ear reconstruction and facilitate early counseling.
