Journal de radiologie · 1995
[Preoperative X-ray computed tomographic evaluation of major aplasia of the ear in children].
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Lumbroso C, Sebag G, Argyropoulou M, Manach Y, Lallemand D
Аннотация
PURPOSE: To describe computed tomography (CT) findings in congenital aural atresia (CAA) and to illustrate the impact of these findings in the preoperative evaluation.
MATERIALS AND METHODS: Sixty-seven congenital aural atresia (bilateral: 10) in 57 children were studied using high resolution CT. Sections 1.5 mm thick were removed from the coronal and the axial plans without sedation (mean age: 9, 6 years).
RESULTS AND DISCUSSION: A narrow bony external auditory canal (EAC) was present in 24% of the cases. In one of these cases, the EAC contained a cholesteatoma and was consequently a clear indication of surgery. An hyperpneumatized mastoïd (22%), a posterior position of the temporo mandibular joint (16%), and a bulging medial temporal fossa (12%) made the operation much more difficult. The tympanic cavity was small in 68% of the cases, normal in 28% and absent in 4% of the cases without any detectable ossicular chain. Ossicular chain anomalies were present in 91% of the cases. This consisted most frequently of a fusion of the malleus and the incus (76%) with or without fusion to the tympanic wall (33%). Lateral and anterior displacement of the descending portion of the facial nerve was present in 62%. Oval and round windows were normal in 86% of the cases. A soft tissue opacity (33%) in the tympanic cavity made it difficult to evaluate the stapes, the incudo stapedial articulation, and the facial nerve. Simultaneous abnormalities of inner ear were exceptional (1 case).
CONCLUSION: High resolution CT is the best method in CAA evaluation and for guiding the planning of the surgical correction.
MATERIALS AND METHODS: Sixty-seven congenital aural atresia (bilateral: 10) in 57 children were studied using high resolution CT. Sections 1.5 mm thick were removed from the coronal and the axial plans without sedation (mean age: 9, 6 years).
RESULTS AND DISCUSSION: A narrow bony external auditory canal (EAC) was present in 24% of the cases. In one of these cases, the EAC contained a cholesteatoma and was consequently a clear indication of surgery. An hyperpneumatized mastoïd (22%), a posterior position of the temporo mandibular joint (16%), and a bulging medial temporal fossa (12%) made the operation much more difficult. The tympanic cavity was small in 68% of the cases, normal in 28% and absent in 4% of the cases without any detectable ossicular chain. Ossicular chain anomalies were present in 91% of the cases. This consisted most frequently of a fusion of the malleus and the incus (76%) with or without fusion to the tympanic wall (33%). Lateral and anterior displacement of the descending portion of the facial nerve was present in 62%. Oval and round windows were normal in 86% of the cases. A soft tissue opacity (33%) in the tympanic cavity made it difficult to evaluate the stapes, the incudo stapedial articulation, and the facial nerve. Simultaneous abnormalities of inner ear were exceptional (1 case).
CONCLUSION: High resolution CT is the best method in CAA evaluation and for guiding the planning of the surgical correction.