Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing 100730, China.
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing 100730, China.
Am J Otolaryngol. 2024 Sep-Oct;45(5):104430. doi: 10.1016/j.amjoto.2024.104430. Epub 2024 Jul 20.
To analyze anatomic variations of the temporal bone in congenital aural atresia (CAA) and their correlation with the Jahrsdoerfer score, in order to guide clinical selection of surgical treatment methods.
We retrospectively studied 53 patients (72 ears) with unilateral or bilateral CAA, including 34 ears with normal hearing as controls. Audiological and imaging data were collected and analyzed. We evaluated the Jahrsdoerfer score and anatomical variations, including tegmen mastoideum position, anterior sigmoid sinus displacement, and elevated jugular bulb.
The average air conduction hearing threshold (PTA4) ranged from 0.5 to 4 kHz was 65.48 ± 8.19 dBHL, with an average Jahrsdoerfer score of 4.93 ± 2.78. In CAA group, there was a higher prevalence and severity of anterior sigmoid sinus and low position of the tegmen mastoideum (P < 0.01). However, there was no significant difference in incidence rates among groups with high jugular bulb (P > 0.05). Anterior sigmoid sinus and high jugular bulb showed no correlation with the Jahrsdoerfer score, while the low position of the tegmen mastoideum had a weak correlation. The Jahrsdoerfer score did not adequately predict temporal bone anatomical abnormalities in CAA patients.
CAA exhibit a higher incidence and greater severity of temporal bone anatomical abnormalities compared to the control group, and the Jahrsdoerfer score inadequately assesses these abnormalities. Anomalies like low position of the tegmen mastoideum, anterior sigmoid sinus, and high jugular bulb should also be considered as independent factors influencing surgical decisions for atresiaplasty.
分析先天性耳闭锁（CAA）患者颞骨解剖变异及其与 Jahrsdoerfer 评分的相关性，以指导临床手术治疗方法的选择。
回顾性分析 53 例（72 耳）单侧或双侧 CAA 患者的临床资料，其中 34 耳听力正常作为对照组。收集并分析患者的听力学和影像学资料，评估 Jahrsdoerfer 评分及解剖变异，包括鼓室盖位置、乙状窦前移位和颈静脉球高位。
气导平均听阈（PTA4）0.5～4 kHz 为 65.48±8.19 dBHL，平均 Jahrsdoerfer 评分为 4.93±2.78。CAA 组患者乙状窦前移位和鼓室盖低位的发生率和严重程度均较高（P<0.01），但颈静脉球高位的发生率组间差异无统计学意义（P>0.05）。乙状窦前移位和颈静脉球高位与 Jahrsdoerfer 评分无相关性，而鼓室盖低位与 Jahrsdoerfer 评分呈弱相关。Jahrsdoerfer 评分不能充分预测 CAA 患者颞骨解剖异常。
CAA 患者颞骨解剖异常的发生率和严重程度均高于对照组，且 Jahrsdoerfer 评分不能充分评估这些异常。鼓室盖低位、乙状窦前移位和颈静脉球高位等异常也应作为影响鼓室成形术决策的独立因素。
