Preoperative evaluation and surgical outcomes of congenital aural atresia
Yıl: 2015 Cilt: 3 Sayı: 1 Sayfa Aralığı: 8 - 12 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022
Preoperative evaluation and surgical outcomes of congenital aural atresia
Öz: Objectives: In this study we aimed to investigate the effectof preoperative evaluation on functional surgical outcomes incongenital aural atresia surgery which is one of the most challengingprocedures of otolaryngology. Patients and Methods: Twelve patients (8 males, 4 females; meanage 12.9±6.8 years; range 6 to 32 years) who underwent surgery forunilateral congenital aural atresia in our clinic between October2007 and April 2013 were included in this study. All patientswere performed pre- and postoperative physical examination, andaudiologic and radiologic evaluation. Patients were preoperativelyevaluated according to Altmanns classification and Jahrsdorferssurgery indication classification. All patients were operated undergeneral anesthesia using transatretic (anterior) approach. Results: According to preoperative evaluation, three patients hadAltmann type 1 minor malformation and nine patients had type 2moderate malformation. No patient had type 3 major malformation.Congenital cholesteatoma was detected in two patients. Accordingto Jahrsdorfers surgery indication classification, three patients wereexcellent, four patients were very good, four patients were good andone patient was fair candidates for functional surgery. Mean air- bone gap was 43±4.1 (range 38-50) dB at postoperative sixth week,36.3±3.4 (range 30-42) dB at postoperative third month, 30.4±2.6(range 28-35) dB at postoperative sixth month, and 30.2±2.1 (range25-35) at postoperative 12th month. One patient (9%) developedpostoperative infection, and two patients (18%) developed restenosis. Conclusion: Preoperative evaluation of patients in congenital auralatresia surgery is of vital importance in terms of surgical success.Obtaining successful surgical and functional outcomes is stronglyrelated to preoperative evaluation and postoperative follow-upalong with surgical technique and surgeons experience.
Anahtar Kelime: Konular:
Doğ uştan aural atrezinin ameliyat öncesi değerlendirilmesi ve cerrahi sonuçları
Öz: A maç: Bu çalışmada otolarengolojinin en zor işlemlerindenbiri olan doğuştan aural atrezi cerrahisinde ameliyat öncesideğerlendirmenin fonksiyonel cerrahi sonuçlar üzerine etkisiaraştırıldı. Hastalar ve Yöntemler: Bu çalışmaya Ekim 2007 - Nisan 2013tarihleri arasında kliniğimizde tek taraflı doğuştan aural atrezinedeni ile ameliyat edilen 12 hasta (8 erkek, 4 kız; ort. yaş 12.9±6.8yıl; dağılım 6-32 yıl) dahil edildi. Tüm hastalara ameliyat öncesive sonrası fizik muayene ile odyolojik ve radyolojik değerlendirmeyapıldı. Hastalar ameliyat öncesi Altmann sınıflaması veJahrsdorfer cerrahi endikasyon sınıflamasına göre değerlendirildi.Hastaların tümü transatrezik (anterior) yaklaşım kullanılarakgenel anestezi altında ameliyat edildi. Bulgular: Ameliyat öncesi değerlendirmeye göre, üç hastadaAltmann tip 1 minör malformasyon ve dokuz hastada tip 2 ortamalformasyon vardı. Hiçbir hastada tip 3 majör malformasyonyoktu. İki hastada doğuştan kolesteotom saptandı. Jahrsdorfer incerrahi endikasyon sınıflamasına göre, fonksiyonel cerrahi içinüç hasta mükemmel, dört hasta çok iyi, dört hasta iyi ve birhasta orta adaylardı. Ortalama hava-kemik aralığı ameliyatsonrası altıncı haftada 43±4.1 (dağılım 38-50) dB, üçüncü ayda36.3±3.4 (dağılım 30-42) dB, altıncı ayda 30.4±2.6 (dağılım28-35) dB ve 12. ayda 30.2±2.1 (dağılım 25-35) dB idi. Birhastada (%9) ameliyat sonrası enfeksiyon, iki hastada (%18)restenoz gelişti. Sonuç: Doğuştan aural atrezi cerrahisinde hastaların ameliyatöncesi değerlendirilmesi cerrahi başarı açısından büyük önemtaşır. Cerrahi ve fonksiyonel açıdan başarılı sonuçlar elde etmekcerrahi tekniği ve cerrahın deneyiminin yanı sıra ameliyat öncesideğerlendirme ve ameliyat sonrası takibe bağlıdır.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. De la Cruz A, Linthicum FH Jr, Luxford WM. Congenital atresia of the external auditory canal. Laryngoscope 1985;95:421-7. 2. Kösling S, Omenzetter M, Bartel-Friedrich S. Congenital malformations of the external and middle ear. Eur J Radiol 2009;69:269-79. 3. Crabtree JA, Harker LA. Developmental anomalies of the ear. In: Cummings CW, Frederickson JM, Harker LA, Krausse CJ, Schüller DE, editors. Otolaryngology Head and Neck Surgery. 2nd ed. St. Louis: Mosby; 1993. p. 2746-55. 4. Oliver ER, Hughley BB, Shonka DC, Kesser BW. Revision aural atresia surgery: indications and outcomes. Otol Neurotol 2011;32:252-8. 5. Teufert KB, De la Cruz A. Advances in congenital aural atresia surgery: effects on outcome. Otolaryngol Head Neck Surg 2004;131:263-70. 6. Beahm EK, Walton RL. Auricular reconstruction for microtia: part I. Anatomy, embryology, and clinical evaluation Plast Reconstr Surg 2002;109:2473-82. 7. Kaga K, Setou M, Nakamura M. Bone-conducted sound lateralization of interaural time difference and interaural intensity difference in children and a young adult with bilateral microtia and atresia of the ears. Acta Otolaryngol 2001;121:274-7. 8. Moore DR. Critical periods for binaural interaction and spatial representation. Acta Otolaryngol Suppl 1986;429:51-5. 9. Linstrom CJ , Aziz MH, Romo T 3rd. Unilateral aural atresia in childhood: case selection and rehabilitation. J Otolaryngol 1995;24:168-79. 10. Granström G, Bergström K, Tjellström A. The bone- anchored hearing aid and bone-anchored epithesis for congenital ear malformations. Otolaryngol Head Neck Surg 1993;109:46-53. 11. De la Cruz A, Chandradekhor SJ . Auditory canal and timpanum. In: Cummings CW, Frederickson JM, Harker LA, Krausse CJ , Schüller DE, editors. Otolaryngology Head and Neck Surgery. 3nd ed. St. Louis: Mosby; 1998. p. 454-60. 12. Lambert PR, Dodson EE. Congenital malformations of the external auditory canal. Otolaryngol Clin North Am 1996;29:741-60. 13. Chang SO, Jeon SJ , Jeong HS, Kim CS. Prevention of postoperative meatal stenosis with anteriorly and inferiorly based periosteal flaps in congenital aural atresia surgery. Otol Neurotol 2002;23:25-8. 14. Tollefson TT. Advances in the treatment of microtia. Curr Opin Otolaryngol Head Neck Surg 2006;14:412-22. 15. Chandrasekhar SS, De la Cruz A, Garrido E. Surgery of congenital aural atresia. Am J Otol 1995;16:713-7. 16. Battelino S, Hocevar-Boltezar I, Zargi M. Intraoperative use of mitomycin C in fibrous atresia of the external auditory canal. Ear Nose Throat J 2005;84:776-9. 17. Jahrsdoerfer RA. External auditory canal atresia. In: Lalwani AK, Grundfast KM, editors. Pediatric Otology and Neurotology. Philadelphia: Lippincott-Raven Publishers; 1998. p. 533-40 18. Yotsuyanagi T, Urushidate S, Nihei Y, Yokoi K, Sawada Y. Reconstruction of congenital stenosis of external auditory canal with a postauricular chondrocutaneous flap. Plast Reconstr Surg 1998;102:2320-4. 19. Dhooge IJ, Vermeersch HF. The use of two pedicled skin flaps in the surgical treatment of acquired atresia of the outer ear canal. Clin Otolaryngol Allied Sci 1999;24:58-60. 20. McCulloch CA, Tenenbaum HC, Fair CA, Birek C. Site-specific regulation of osteogenesis: maintenance of discrete levels of phenotypic expression in vitro. Anat Rec 1989;223:27-34. 21. Lambert PR. Congenital aural atresia: stability of surgical results. Laryngoscope 1998;108:1801-5. 22. Yetişer S. Middle Ear Ossicular Reconstruction in Congenital Aural Atresia and Anomalies. Turkiye Klinikleri J E.N.T.Special Topics 2008;1:31-4. 23. Jahrsdoerfer RA, Hall JW 3rd. Congenital malformations of the ear. Am J Otol 1986;7:267-9.
| APA | ERYILMAZ M, KİBAR A, VARSAK Y, ARBAĞ H (2015). Preoperative evaluation and surgical outcomes of congenital aural atresia. , 8 - 12. |
| Chicago | ERYILMAZ MEHMET AKİF,KİBAR Ahmet,VARSAK Yasin Kürşad,ARBAĞ Hamit Preoperative evaluation and surgical outcomes of congenital aural atresia. (2015): 8 - 12. |
| MLA | ERYILMAZ MEHMET AKİF,KİBAR Ahmet,VARSAK Yasin Kürşad,ARBAĞ Hamit Preoperative evaluation and surgical outcomes of congenital aural atresia. , 2015, ss.8 - 12. |
| AMA | ERYILMAZ M,KİBAR A,VARSAK Y,ARBAĞ H Preoperative evaluation and surgical outcomes of congenital aural atresia. . 2015; 8 - 12. |
| Vancouver | ERYILMAZ M,KİBAR A,VARSAK Y,ARBAĞ H Preoperative evaluation and surgical outcomes of congenital aural atresia. . 2015; 8 - 12. |
| IEEE | ERYILMAZ M,KİBAR A,VARSAK Y,ARBAĞ H "Preoperative evaluation and surgical outcomes of congenital aural atresia." , ss.8 - 12, 2015. |
| ISNAD | ERYILMAZ, MEHMET AKİF vd. "Preoperative evaluation and surgical outcomes of congenital aural atresia". (2015), 8-12. |
| APA | ERYILMAZ M, KİBAR A, VARSAK Y, ARBAĞ H (2015). Preoperative evaluation and surgical outcomes of congenital aural atresia. Kulak Burun Boğaz Uygulamaları, 3(1), 8 - 12. |
| Chicago | ERYILMAZ MEHMET AKİF,KİBAR Ahmet,VARSAK Yasin Kürşad,ARBAĞ Hamit Preoperative evaluation and surgical outcomes of congenital aural atresia. Kulak Burun Boğaz Uygulamaları 3, no.1 (2015): 8 - 12. |
| MLA | ERYILMAZ MEHMET AKİF,KİBAR Ahmet,VARSAK Yasin Kürşad,ARBAĞ Hamit Preoperative evaluation and surgical outcomes of congenital aural atresia. Kulak Burun Boğaz Uygulamaları, vol.3, no.1, 2015, ss.8 - 12. |
| AMA | ERYILMAZ M,KİBAR A,VARSAK Y,ARBAĞ H Preoperative evaluation and surgical outcomes of congenital aural atresia. Kulak Burun Boğaz Uygulamaları. 2015; 3(1): 8 - 12. |
| Vancouver | ERYILMAZ M,KİBAR A,VARSAK Y,ARBAĞ H Preoperative evaluation and surgical outcomes of congenital aural atresia. Kulak Burun Boğaz Uygulamaları. 2015; 3(1): 8 - 12. |
| IEEE | ERYILMAZ M,KİBAR A,VARSAK Y,ARBAĞ H "Preoperative evaluation and surgical outcomes of congenital aural atresia." Kulak Burun Boğaz Uygulamaları, 3, ss.8 - 12, 2015. |
| ISNAD | ERYILMAZ, MEHMET AKİF vd. "Preoperative evaluation and surgical outcomes of congenital aural atresia". Kulak Burun Boğaz Uygulamaları 3/1 (2015), 8-12. |
