HEAR MAPS a classification for congenital microtia/atresia based on the evaluation of 742 patients.
OBJECTIVE
Describe anatomical and radiological findings in 742 patients evaluated for congenital aural atresia and microtia by a multidisciplinary team. Develop a new classification method to enhance multidisciplinary communication regarding patients with congenital aural atresia and microtia.


METHODS
Retrospective chart review with descriptive analysis of findings arising from the evaluation of patients with congenital atresia and microtia between January 2008 and January 2012 at a multidisciplinary tertiary referral center.


RESULTS
We developed a classification method based on the acronym HEAR MAPS (Hearing, Ear [microtia], Atresia grade, Remnant earlobe, Mandible development, Asymmetry of soft tissue, Paralysis of the facial nerve and Syndromes). We used this method to evaluate 742 consecutive congenital atresia and microtia patients between 2008 and January of 2012. Grade 3 microtia was the most common external ear malformation (76%). Pre-operative Jahrsdoerfer scale was 9 (19%), 8 (39%), 7 (19%), and 6 or less (22%). Twenty three percent of patients had varying degrees of hypoplasia of the mandible. Less than 10% of patients had an identified associated syndrome.


CONCLUSIONS
Patients with congenital aural atresia and microtia often require the intervention of audiology, otology, plastic surgery, craniofacial surgery and speech and language professionals to achieve optimal functional and esthetic reconstruction. Good communication between these disciplines is essential for coordination of care. We describe our use of a new classification method that efficiently describes the physical and radiologic findings in microtia/atresia patients to improve communication amongst care providers.
California Ear Institute, 1900 University Avenue Suite 101, E Palo Alto, CA 94303, United States. jbr@calear.com
Joseph B
JB
Roberson
Hernan
H
Goldsztein
Ashley
A
Balaker
Stephen A
SA
Schendel
John F
JF
Reinisch
D000015:Abnormalities, Multiple / Q000145:classification* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000145:classification* / Q000601:surgery; D065817:Congenital Microtia; D004423:Ear / Q000002:abnormalities* / Q000601:surgery; D004427:Ear Diseases / Q000145:classification* / Q000151:congenital / Q000601:surgery; D004432:Ear, Middle / Q000002:abnormalities*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult
Aural atresia; Congenital ear anomalies; Microtia; Otology