Abstract
Hearing loss associated with craniofacial microsomia (CFM) requires a team approach for evaluation, diagnosis, aural rehabilitation, and surgical intervention. Age-appropriate hearing assessment is essential to appropriately diagnose associated hearing loss and provide early intervention services. Therapy is based on the anomalies associated with the craniofacial microsomia and can vary from ear-level hearing aids to bone conduction sound processors (BCSP), using either band or osseointegrated implant-retention systems to atresia repair. For many patients with favorable anatomy, aural atresia repair allows for improved conductive hearing and quality of life. In summary, unilateral hearing loss (UHL) should be treated early and appropriately to aid in optimal speech and language development, as well as age-appropriate school performance.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Mitchell RM, Saltzman BS, Norton SJ, Harrison RG, Heike CL, Luquetti DV, et al. Hearing loss in children with craniofacial microsomia. Cleft Palate Craniofac J. 2017;54(6):656–63.
Heike CL, Luquetti DV, Hing AV. Craniofacial microsomia overview. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K, editors. GeneReviews®. Seattle: University of Washington; 1993.
Vento AR, LaBrie RA, Mulliken JB. The O.M.E.N.S. Classification of hemifacial microsomia. Cleft Palate Craniofac J. 1991;28:68–76; discussion 77.
Roberson JB Jr, Goldsztein H, Balaker A, Schendel SA, Reinisch JF. HEAR MAPS a classification for congenital microtia/atresia based on the evaluation of 742 patients. Int J Pediatr Otorhinolaryngol. 2013;77:1551–4.
Bly RA, Bhrany AD, Murakami CS, Sie KC. Microtia reconstruction. Facial Plast Surg Clin North Am. 2016;24:577–91.
Abdel-Aziz M. Congenital aural atresia. J Craniofac Surg. 2013;24:e418–22.
Dougherty W, Kesser BW. Management of conductive hearing loss in children. Otolaryngol Clin N Am. 2015;48:955–74.
Qin FH, Zhang TY, Dai P, Yang L. Anatomic variants on computed tomography in congenital aural atresia and stenosis. Clin Exp Otorhinolaryngol. 2015;8:320–8.
Cole RR, Jahrsdoerfer RA. The risk of cholesteatoma in congenital aural stenosis. Laryngoscope. 1990;100:576–8.
Terzis JK, Anesti K. Developmental facial paralysis: a review. J Plast Reconstr Aesthet Surg. 2011;64:1318–33.
Sataloff RT. Embryology of the facial nerve and its clinical applications. Laryngoscope. 1990;100:969–84.
Zhao S, Han D, Wang Z Li J, Qian Y, Ren Y, et al. An imaging study of the facial nerve canal in congenital aural atresia. Ear Nose Throat J. 2015;94:E6–13.
Jahrsdoerfer RA. The facial nerve in congenital middle ear malformations. Laryngoscope. 1981;91:1217–25.
Jahrsdoerfer RA. Transposition of the facial nerve in congenital aural atresia. Am J Otol. 1995;16:290–4.
Hitier M, Zhang M, Labrousse M, Barbier C, Patron V, Moreau S. Persistent stapedial arteries in human: from phylogeny to surgical consequences. Surg Radiol Anat. 2013;35:883–91.
Moreano EH, Paparella MM, Zelterman D, Goycoolea MV. Prevalence of facial canal dehiscence and of persistent stapedial artery in the human middle ear: a report of 1000 temporal bones. Laryngoscope. 1994;104:309-320.
Caughey RJ, Jahrsdoerfer RA, Kesser BW. Congenital cholesteatoma in a case of congenital aural atresia. Otol Neurotol. 2006;27:934–6.
Abdel-Aziz M. Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report. BMC Ear Nose Throat Disord. 2012;12:6.
Kosling S, Omenzetter M, Bartel-Friedrich S. Congenital malformations of the external and middle ear. Eur J Radiol. 2009;69:269–79.
Altmann F. Congenital atresia of the ear in man and animals. Ann Otol Rhinol Laryngol. 1955;64:824–58.
Jahrsdoerfer RA, Yeakley JW, Aguilar EA, Cole RR, Gray LC. Grading system for the selection of patients with congenital aural atresia. Am J Otol. 1992;13:6–12.
Yellon RF, Branstetter BFT. Prospective blinded study of computed tomography in congenital aural atresia. Int J Pediatr Otorhinolaryngol. 2010;74:1286–91.
Dedhia K, Yellon RF, Branstetter BF, Egloff AM. Anatomic variants on computed tomography in congenital aural atresia. Otolaryngol Head Neck Surg. 2012;147:323–8.
Kesser BW, Krook K, Gray LC. Impact of unilateral conductive hearing loss due to aural atresia on academic performance in children. Laryngoscope. 2013;123:2270–5.
Jensen DR, Grames LM, Lieu JE. Effects of aural atresia on speech development and learning: retrospective analysis from a multidisciplinary craniofacial clinic. JAMA Otolaryngol Head Neck Surg. 2013;139:797–802.
Saliba I, Froehlich P, Bouhabel S. One-stage vs. two-stage BAHA implantation in a pediatric population. Int J Pediatr Otorhinolaryngol. 2012;76:1814–8.
Heubi C, Choo D. Updated optimal management of single-sided deafness. Laryngoscope. 2017;127(8):1731–2.
Dimitriadis PA, Carrick S, Ray J. Intermediate outcomes of a transcutaneous bone conduction hearing device in a paediatric population. Int J Pediatr Otorhinolaryngol. 2017;94:59–63.
Doshi J, Sheehan P, McDermott AL. Bone anchored hearing aids in children: an update. Int J Pediatr Otorhinolaryngol. 2012;76:618–22.
Cremers CW, O'Connor AF, Helms J, Snik ADFM. International consensus on vibrant Soundbridge® implantation in children and adolescents. Int J Pediatr Otorhinolaryngol. 2010;74:1267–9.
Declau F, Cremers C, Van de Heyning P. Diagnosis and management strategies in congenital atresia of the external auditory canal. Study Group on Otological Malformations and Hearing Impairment. Br J Audiol. 1999;33:313–27.
Schuknecht HF. Congenital aural atresia. Laryngoscope. 1989;99:908–17.
Jahrsdoerfer RA. Congenital atresia of the ear. Laryngoscope. 1978;88:1–48.
Yeakley JW, Jahrsdoerfer RA. CT evaluation of congenital aural atresia: what the radiologist and surgeon need to know. J Comput Assist Tomogr. 1996;20:724–31.
Glasscock ME 3rd, Schwaber MK, Nissen AJ, Jackson CG. Management of congenital ear malformations. Ann Otol Rhinol Laryngol. 1983;92:504–9.
Sharma A, Dorman MF, Spahr AJ. A sensitive period for the development of the central auditory system in children with cochlear implants: implications for age of implantation. Ear Hear. 2002;23:532–9.
Johnson KL, Nicol T, Zecker SG, Kraus N. Developmental plasticity in the human auditory brainstem. J Neurosci. 2008;28:4000–7.
James AL, Papsin BC. Cochlear implant surgery at 12 months of age or younger. Laryngoscope. 2004;114:2191–5.
Service GJ, Roberson JB Jr. Current concepts in repair of aural atresia. Curr Opin Otolaryngol Head Neck Surg. 2010;18:536–8.
Roberson JB Jr, Reinisch J, Colen TY, Lewin S. Atresia repair before microtia reconstruction: comparison of early with standard surgical timing. Otol Neurotol. 2009;30:771–6.
Zhao S, Wang D, Han D, Gong S, Ma X, Li Y, et al. Integrated protocol of auricle reconstruction combined with hearing reconstruction. Acta Otolaryngol. 2012;132:829–33.
Teufert KB, De la Cruz A. Advances in congenital aural atresia surgery: effects on outcome. Otolaryngol Head Neck Surg. 2004;131:263–70.
Yoshinaga-Itano C, Coulter D, Thomson V. Developmental outcomes of children with hearing loss born in Colorado hospitals with and without universal newborn hearing screening programs. Semin Neonatol. 2001;6:521–9.
Moeller MP. Early intervention and language development in children who are deaf and hard of hearing. Pediatrics. 2000;106:E43.
American Academy of Pediatrics. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120:898–921.
Lieu JE. Management of children with unilateral hearing loss. Otolaryngol Clin N Am. 2015;48:1011–26.
Culbertson JL, Gilbert LE. Children with unilateral sensorineural hearing loss: cognitive, academic, and social development. Ear Hear. 1986;7:38–42.
Tharpe AM. Unilateral and mild bilateral hearing loss in children: past and current perspectives. Trends Amplif. 2008;12:7–15.
Verhagen CV, Hol MK, Coppens-Schellekens W, Snik AF, Cremers CW. The Baha Softband. A new treatment for young children with bilateral congenital aural atresia. Int J Pediatr Otorhinolaryngol. 2008;72:1455–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Miller, C., Bly, R.A., Sie, K.C.Y. (2019). Management of Conductive Hearing Loss Associated with Aural Atresia and Microtia. In: Reinisch, J., Tahiri, Y. (eds) Modern Microtia Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-16387-7_9
Download citation
DOI: https://doi.org/10.1007/978-3-030-16387-7_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-16386-0
Online ISBN: 978-3-030-16387-7
eBook Packages: MedicineMedicine (R0)