Abstract
A subset of patients presents with unilateral conductive hearing loss, a normal pinna or grade I microtia, and mild external auditory canal stenosis. The physical findings of microtia and a small external canal are commonly absent or subtle in this group of patients, who are being commonly referred for imaging to evaluate isolated conductive hearing loss. We present a case series of patients with unilateral conductive hearing loss and characteristic ossicular abnormalities, commonly anterior fixation of the malleus. All patients had a significantly increased distance from the cochlear promontory to the handle of the malleus and an abnormal incudostapedial angle, indicative of an abnormal ossicular position and/or morphology. Successful surgical reconstruction of the ossicular chain was attempted and accomplished in 3 patients.
Highlights
We describe the clinical presentation and audiometric and High-resolution CT (HRCT) findings in a group of patients with unilateral conductive hearing loss (CHL) and a normal or minimally abnormal pinna associated with mild stenosis of the external auditory canal (EAC)
Abnormal orientation of the handle of the malleus with an abnormally increased distance to the cochlear promontory was present in all ears
Most patients in this series had normal external examination findings on the initial evaluation when unilateral CHL was the sole reason for obtaining HRCT. 3D volumetric reconstruction of the CT dataset may be useful in assessing minor external ear malformations to aid in a potential diagnosis
Summary
These patients present with conductive hearing loss related to stenosis or atresia of the external auditory canal (EAC).[4] Ossicular anomalies such as absence, fixation, and abnormal fusion have been described in children with or without EAC stenosis or atresia. We describe the clinical presentation and audiometric and HRCT findings in a group of patients with unilateral CHL and a normal or minimally abnormal pinna associated with mild stenosis of the EAC.
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