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FEBRUARY 2017 | The Surgical Technologist | 61 Congenital Aural Atresia L E A R N I N G O B J E C T I V E S s Review the anatomy associated with congenital aural atresia s Examine the seven essential steps to this procedure s Recall the set up and draping protocols specific to this procedure s List the considerations on the Jahrsdoerfer grading scale s Explain how the procedure allows for a child to hear for the first time This birth defect may affect the ossicles (middle ear bones – malleus [hammer], incus [anvil], and stapes [stirrup]), ear canal and external auricle. There are four grades. Grade 1 is when the external ear is smaller than normal and the ear has mostly normal anatomy. Grade 2 is when part of the ear looks normal, usually the lower lobe, although the canal may be normal, small or completely closed. Grade 3 is when the ear has “peanut-shaped” skin and cartilage, and there is no canal. Grade 4 is when there is a complete absence of both the external ear and ear canal. 2 The Jahrsdoerfer grading scale is a valuable tool in the preopera- tive evaluation of these patients. 3 A preoperative temporal bone CT scan is performed and evaluated. 4 Nine critical areas of temporal bone anatomy are given a number. These are the Jacobson nerve, incus, sta- pes, footplate, pedial tendon, chordae timpita, malleus, oval window and facial nerve. Suzanne Cunn i ff, cst, csfa- cvs Congenital aural atresia is a condition that involves the ear canal, and where the external auditory ear canal to the middle ear ossicles is absent or closed. This surgical procedure, which allows a child to hear, involves drilling into the temporal bone and placing a layer of skin over the newly made canal to allow sound to reach the middle ear. 1 Anoth- er procedure commonly associated with atresia is microtia. Microtia reconstructs the external auricle.