Predictive Factors for Hearing Outcomes After Canaloplasty in Patients With Congenital Aural Atresia

Objective: The aim of this study was to determine the most important factors in preoperative imaging, including components of Jahrsdoefer score (J score), and favorable prognostic factors for postoperative hearing results after canaloplasty for congenital aural atresia. Study Design: Retrospective review of medical records. Setting, Patients, Intervention, Main Outcome Measure: One hundred eight patients who underwent canaloplasty by a single surgeon between January 2011 and July 2014 were included. The influence of the following factors on the success for restoring of hearing was evaluated by univariable and multivariable logistic regression analyses: sex, atretic side, total J score, each component of Jahrsdoerfer grading scale, incudostapedial joint angle, inferior displacement of the tegmen, middle ear height, and inner ear anomaly. Results: Successful hearing outcome was defined as postoperative air conduction <= 40 dB at 3 months after surgery, and it was achieved in 74 of 108 ears (70.5%). Univariable analysis revealed that the total J score, course of the facial nerve, presence of the malleus-incus complex, pneumatization of the mastoid, and middle ear height were significant as favorable predictive factors. Multivariable analysis revealed that middle ear height and inferior displacement of the tegmen were significant as favorable predictive factors. Inferior displacement of the tegmen was the most significant factor by the stepwise selection method in the final model. Conclusion: Middle ear height and inferior displacement of the tegmen are useful factors in predicting favorable hearing results after canaloplasty for congenital aural atresia. These factors might have a useful prognostic value supplementary to the J score.