title: Congenital absence of the oval window: diagnosis, surgery, and audiometric outcomes.
abstract: OBJECTIVE
  To review the surgical management and outcomes of patients with congenital absence of the oval window (CAOW) undergoing the oval window drill-out (OWD) procedure.
  
  
  METHODS
  A retrospective chart review of patients with CAOW seen in a tertiary care otologic practice between 1991 and 2006.
  
  
  METHODS
  Patients with CAOW undergoing OWD procedure.
  
  
  METHODS
  Findings at surgery and preoperative and postoperative audiometric outcomes (air and bone conduction thresholds; speech reception threshold).
  
  
  RESULTS
  Seventeen ears underwent OWD for CAOW. Four cases were aborted. For the 13 subject ears, average 1-month postoperative 4-tone air conduction and speech reception thresholds were significantly lower than preoperative thresholds. Long-term follow-up (average, 20 months) air conduction and speech reception thresholds were also significantly lower but showed a slight worsening of thresholds compared with the 1-month postoperative results. Speech discrimination scores and bone conduction thresholds remained stable.
  
  
  CONCLUSIONS
  OWD may be a viable operation for patients with CAOW, although longer follow-up is needed. Given the mixed hearing results in the current patient series, we have tempered our enthusiasm for this operation. Technically challenging, this procedure nevertheless can improve patients' hearing with minimal morbidity. Revision surgery did not result in improved outcome.
authors.affiliation: University of Virginia, Department of Otolaryngology-Head and Neck Surgery, Charlottesville, Virginia 22908-0713, USA.
authors.forename: Alessandro
authors.initials: A
authors.lastname: de Alarcon
authors.forename: Robert A
authors.initials: RA
authors.lastname: Jahrsdoerfer
authors.forename: Bradley W
authors.initials: BW
authors.lastname: Kesser
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001844:Bone Conduction; D002648:Child; D002675:Child, Preschool; D004424:Ear Canal / Q000601:surgery; D005260:Female; D006801:Humans; D007188:Incus / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008307:Malleus / Q000000981:diagnostic imaging / Q000601:surgery; D013506:Otologic Surgical Procedures; D010046:Oval Window, Ear / Q000002:abnormalities* / Q000601:surgery*; D012189:Retrospective Studies; D013199:Stapes / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome