Presurgical CT Evaluation of Congenital Aural Atresia

Congenital aural atresia occurs in approximately 1 in 10,000‐20,000 births and may be surgically repaired if the middle ear malformation is limited in character. External auditory canal atresia is difficult to repair surgically, with significant risks and complications. Surgical candidacy in congenital aural atresia is based on multiple factors, central to which are the anatomy of the temporal bone and audiometric findings. High-resolution multidetector CT is the imaging technique of choice for anatomy delineation, although there are some specific indications for MR imaging in presurgical assessment. Various CT grading systems have been developed to determine surgical candidacy and are described in this review. The radiologist's understanding and precise evaluation of important anatomic structures is critical in the assessment of surgical candidacy. This review serves to familiarize the radiologist with various abnormalities seen in congenital aural atresia.

Learning Objectives: Recognize important CT-based classification systems used to determine surgical candidacy and contraindications to surgery for external auditory canal atresia repair, recognize the embryologic origin, and assess the EAC and ossicles in congenital aural atresia.