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Neuroradiology

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01-07-2013 | Head and Neck Radiology

Grading system for the selection of patients with congenital aural atresia for active middle ear implants

Authors: Henning Frenzel, Georg Sprinzl, Gerlig Widmann, Dirk Petersen, Barbara Wollenberg, Christian Mohr

Published in: Neuroradiology | Issue 7/2013

Abstract

Introduction

Active middle ear implants (aMEI) are being increasingly used for hearing restoration in congenital aural atresia. The existing gradings used for CT findings do not meet the requirements for these implants. Some items are expendable, whereas other important imaging factors are missing. We aimed to create a new grading system that could describe the extent of the malformation and predict the viability and challenges of implanting an aMEI.

Methods

One hundred three malformed ears were evaluated using HRCT of the temporal bone. The qualitative items middle ear and mastoid pneumatization, oval window, stapes, round window, tegmen mastoideum displacement and facial nerve displacement were included. An anterior- and posterior round window corridor, oval window and stapes corridor were quantified and novelly included. They describe the size of the surgical field and the sight towards the windows.

Results

The ears were graded on a 16-point scale (16–13 easy, 12–9 moderate, 8–5 difficult, 4–0 high risk). The strength of agreement between the calculated score and the performed implantations was good. The comparison of the new 16-point scale with the Jahrsdoerfer score showed that both were able to conclusively detect the high-risk group; however, the new 16-point scale was able to further determine which malformed ears were favorable for aMEI, which the Jahrsdoerfer score could not do.

Conclusion

The Active Middle Ear Implant Score for aural atresia (aMEI score) allows more precise risk stratification and decision making regarding the implantation. The use of operative corridors seems to have significantly better prognostic accuracy than the Jahrsdoerfer score.

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Title: Grading system for the selection of patients with congenital aural atresia for active middle ear implants
Authors: Henning Frenzel
Georg Sprinzl
Gerlig Widmann
Dirk Petersen
Barbara Wollenberg
Christian Mohr
Publication date: 01-07-2013
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 7/2013
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-013-1177-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Grading system for the selection of patients with congenital aural atresia for active middle ear implants

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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