title: Continuity of the incudostapedial joint: a novel prognostic factor in postoperative hearing outcomes in congenital aural atresia.
abstract: CONCLUSIONS
  Mean incudostapedial joint (ISJ) angulation of atretic ears was statistically wider than ISJ angulation of non-atretic ears. Postoperative hearing results in the narrow tympanoplasty type II (T2) subgroup were better than those in the wide T2 subgroup. In cases of abnormally wide ISJ angulation, we recommend that partial ossicular reconstruction (POR) be used as a surgical means of achieving hearing improvement.
  
  
  OBJECTIVE
  To report the results of ISJ angulation in patients with congenital aural atresia and its effects on postoperative hearing improvement.
  
  
  METHODS
  Patients undergoing canaloplasty with T2 (149 ears) and canaloplasty with POR (32 ears) were enrolled. The T2 group was dichotomized according to an ISJ cut-off of an angle of 120° into the 'narrow' T2 and 'wide' T2 subgroups. The pre- and postoperative air-bone gap (ABG) and ABG change were analyzed.
  
  
  RESULTS
  Mean ISJ angulation of non-atretic ears was 93.06 ± 13.21° and that of atretic ears in the T2 group was 118.39 ± 19.60° (p < 0.001). Mean short- and long-term postoperative ABGs were better in the narrow T2 subgroup than in the wide T2 subgroup (p = 0.01 and 0.03, respectively). The short-term postoperative ABG and ABG change in the POR showed superior results to those of the wide T2 subgroup (p < 0.001 and 0.041, respectively).
authors.affiliation: Department of Otorhinolaryngology, Seoul National University Hospital, Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Jae-Jin
authors.initials: JJ
authors.lastname: Song
authors.forename: Hyun
authors.initials: H
authors.lastname: Chang
authors.forename: Yoon-Seok
authors.initials: YS
authors.lastname: Choi
authors.forename: Jeong Hun
authors.initials: JH
authors.lastname: Jang
authors.forename: Ji-hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Seung Ha
authors.initials: SH
authors.lastname: Oh
authors.forename: Sun O
authors.initials: SO
authors.lastname: Chang
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D001299:Audiometry; D002648:Child; D002675:Child, Preschool; D004424:Ear Canal / Q000002:abnormalities* / Q000601:surgery; D004432:Ear, Middle / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology*; D006311:Hearing Disorders / Q000151:congenital / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009998:Ossicular Prosthesis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*