Jahrsdoerfer et al developed a grading system based on clinical and CT images for a patient with congenital aural atresia. This can help identify patients who may or may not benefit from surgery. The authors are from the University of Texas at Houston.
Evaluation is based on:
(1) CT scans of the affected ear
(2) clinical examination of the head and neck
|
Parameter |
Points |
|
stapes present |
2 |
|
oval window open |
1 |
|
middle ear space |
1 |
|
facial nerve |
1 |
|
malleus/incus complex |
1 |
|
mastoid pneumatized |
1 |
|
incus-stapes connection |
1 |
|
round window |
1 |
|
appearance of the external ear |
1 |
total score =
= SUM(points for all 9 parameters)
|
Total Score |
Likelihood of Surgical Success (Usable Hearing) |
|
10 |
excellent |
|
9 |
very good |
|
8 |
good |
|
7 |
fair |
|
6 |
marginal |
|
<= 5 |
poor |
In a later paper Yeakley et al give criteria for when points are not assigned. This is easier to implement by subtraction from the perfect score.
|
Parameter |
Subtract from Perfect 10 |
|
stapes absent (and not a false finding caused by fluid or soft tissue causing an opacity) |
2 |
|
oval window <= 1 mm in diameter OR window nondefined OR bone density within cleft |
1 |
|
middle ear space < 3 mm OR middle ear nonaerated or opacified OR dysplasia of TMJ |
1 |
|
unfavorable or unpredictable course to the facial nerve |
1 |
|
severe deformity of the malleus/incus complex OR long process of the incus absent OR ossicular dissociation |
1 |
|
mastoid poorly pneumatized and sclerotic |
1 |
|
incus-stapes joint not defined |
1 |
|
round window <= 1 mm (stenotic) |
1 |
|
external ear absent or small mound of skin ("peanut") |
1 |
total score =
= 10 - SUM(points for the 9 parameters)
Specialty: Neurology, Otolaryngology
ICD-10: ,
