TY - JOUR T1 - The “Boomerang” Malleus-Incus Complex in Congenital Aural Atresia JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 2181 LP - 2185 DO - 10.3174/ajnr.A4022 VL - 35 IS - 11 AU - S. Mukherjee AU - B.W. Kesser AU - P. Raghavan Y1 - 2014/11/01 UR - http://www.ajnr.org/content/35/11/2181.abstract N2 - SUMMARY: “Boomerang” malleus-incus fusion deformity is identified on axial high-resolution CT in a subset of patients with congenital aural atresia, and it is associated with an absent incudostapedial joint and stapes capitulum and attachment of the incus to the tympanic segment of the facial nerve canal. Twelve patients with this deformity were identified on a retrospective review of imaging from a cohort of 673 patients with congenital aural atresia, with surgical confirmation in 9 of these patients. Eight of 9 patients underwent partial ossicular replacement prosthesis reconstruction with improvement in hearing outcome. We hypothesize that the boomerang anomaly represents a more severe ossicular anomaly than is normally seen in congenital aural atresia, arising from an arrest earlier in the embryonic development of the first and second branchial arch. This has potentially important implications for surgical planning because hearing outcomes with placement of prosthesis may not be as good as with conventional atresia surgery, in which reconstruction is performed with the patient's native ossicular chain. CAAcongenital aural atresiaHRCThigh-resolution CTPORPpartial ossicular replacement prosthesis ER -