title: Correlation between microtia and temporal bone malformation evaluated using grading systems.
abstract: OBJECTIVE
  To evaluate the relationships between temporal bone abnormalities and the severity of microtia in Japanese patients using objective grading systems.
  
  
  METHODS
  Retrospective case series study conducted between 1992 and 2003.
  
  
  METHODS
  Academic, tertiary care, referral medical center.
  
  
  METHODS
  One hundred forty-two ears of 109 Japanese patients (85 male and 24 female patients; mean age, 12.8 years [range, 2-36 years]) with microtia.
  
  
  METHODS
  The severity of microtia was classified according to Marx classification. Developmental abnormalities of the temporal bone were evaluated by a computed tomographic (CT) scoring system modified after the system used by Jahrsdoerfer and colleagues, using high-resolution CT scans of the temporal bone. Correlations between the scores obtained from these 2 grading systems were evaluated using a nonparametric statistical method.
  
  
  RESULTS
  Male preponderance and incidence of bilateral cases of approximately 30% were observed in our Japanese patients with microtia. There was no significant difference in the severity of microtia between unilateral and bilateral cases. The mean +/- SEM total points in the CT scoring system (full marks, 10) was 7.9 +/- 0.4 for grade I microtia, 6.6 +/- 0.6 for grade II, and 6.4 +/- 0.3 for grade III; the total points correlated inversely with the microtia grade. Development of the auricle correlated significantly with aeration in the middle ear spaces but not with ossicular development or formation of the oval/round windows. Proportion of acceptable surgical candidates according to the CT scoring system (>5 points) was 79% for grade I microtia, 52% for grade II microtia, and 65% for grade III microtia.
  
  
  CONCLUSIONS
  The principle "the better developed the auricle, the better developed middle ear" was confirmed in Japanese patients with microtia; however, even with grade II/III microtia, more than half of the patients were considered suitable for atresia surgery.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. shinchan-tky@umin.ac.jp
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Ishimoto
authors.forename: Ken
authors.initials: K
authors.lastname: Ito
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamasoba
authors.forename: Kenji
authors.initials: K
authors.lastname: Kondo
authors.forename: Shotaro
authors.initials: S
authors.lastname: Karino
authors.forename: Hideki
authors.initials: H
authors.lastname: Takegoshi
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Kaga
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004431:Ear, External / Q000002:abnormalities*; D004432:Ear, Middle / Q000002:abnormalities; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013701:Temporal Bone / Q000002:abnormalities*