Anatomical Barriers in Congenital Canal Atresia Affecting Operative Candidacy and Patient Selection

Abstract
Background:
By analyzing the temporal CT images and intraoperative findings in patients with canal atresia and comparing those with images and intraoperative findings of normal canals, we further understand ex‌ternal and middle ear development to improve surgical candida‌cy selection. In addition to the status of the ossicu-lar chain, the degree of development of the tympanic cavity and mastoid, and the course of the facial nerve, the most important information taken from CT and intraoperative findings are the dimensions of the future canal. This study will focus on the dimensions of the created canal and whether it is correctable or uncorrectable.
Aim of the study:
To match the C.T. scan and intraoperative findings with the surgical outcome for patients with congenital canal atresia for proper surgical candidacy considerations.
Patients and methods:
A prospective, study conducted from September 2017 to December 2020 on 50 congenital canal atresia patients. All patients have undergone surgical meatocanaloplasty. Intraoperative data collection was done to be matched with preoperative C.T. data and correlated later on with the final outcome.

Results:
Follow up of all patients recorded progressive circumferential narrowing of their canals and progressive reduction of their depth. Final outcome showed narrow short canals in all patients.
Conclusion:
Analysis of the C.T. data and intraoperative findings in patients of congenital canal atresia showed uncorrectable dimensions even for those patients with the highest Jahrsdoerfer score due to lack of full dimension consideration.
Keywords: Congenital anatomical Barriers, Non corrected dimensions, Congenital Canal Atresia.