Step 1: CT Scan
Atresia repair candidacy is scored from a CT scan on a scale between 1 and 10, loosely corresponding to the chance that hearing within normal range (i.e. an score of 8 represents an 80% chance of restoring hearing to below 25 dB).
Scores of 8, 9, or 10 Atresia repair is recommended
Scores of 6 or 7 Atresia repair is possible
Scores of 0 to 5 Atresia repair is generally not recommended, unless there is concurrent sensorineural hearing loss and the need to wear traditional hearing aids is essential to restore hearingIf the patient is not a good atresia repair candidate, then the BAHA® (Bone Anchored Hearing Appliance) device is also an option for patients over age 5. The BAHA® device can be worn on a headband for children under age 5.
Scans should not be done in children under age 2 ½ solely for the purposes of atresia repair assessment unless there is another medical need requiring them, as scans done earlier may have to be repeated due to mastoid growth, and the atresia repair cannot be done before age 3.
Step 2: Audiogram
A comprehensive air / bone audiogram is helpful in determining whether or not a patient is a good atresia repair candidate. For children under 18 months of age, this is best done through a sedated ABR examination. For children 18 months to 3 years of age, conditioned play or visually reinforced audiometry can generally be performed.
Step 3: Medical Consultation:
If you already have a CT scan, we will review it for you free of charge and let you know whether it is good enough to determine atresia repair candidacy, or if another scan with very specific parameters are required. Scans (either film or CD) should be mailed along with the radiology report and a recent audiogram to:
Attention: Atresia Repair Assessment
California Ear Institute
1900 University Avenue, Suite 101
E. Palo Alto, CA 94303Please only send copies as CDs and films will NOT be returned. Also, please understand that if you send with delivery confirmation, it only means that our building’s centralized mail service has received the scans, it does not mean that they have physically reached us.
Scans should not be done in children under age 2 ½ solely for the purposes of atresia repair assessment unless there is another medical need requiring them, as scans done earlier may have to be repeated due to mastoid growth, and the atresia repair cannot be done before age 3.
Free of Charge? Yes, as a service to those who need help. If you are able, please consider a tax-deductible donation to the Let Them Hear Foundation to help us cover the extra costs of providing this service to those who need help.
Atresia Repair FAQ’s Treatment Options & Alternatives

