RT Journal Article SR Electronic T1 The “Boomerang” Malleus-Incus Complex in Congenital Aural Atresia JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 2181 OP 2185 DO 10.3174/ajnr.A4022 VO 35 IS 11 A1 S. Mukherjee A1 B.W. Kesser A1 P. Raghavan YR 2014 UL http://www.ajnr.org/content/35/11/2181.abstract AB 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