For diagnosis of congenital atresia we have the following resources at our disposal: radiology, for the morphologic analysis of the malformation; audiology, for functional classifications, and, in exceptional cases, otoscopy.
It is our routine procedure in the radiological study of each case to depend on three projections: the lateral of Schüller, the transversal of Stenvers, and the axial of Mayer. We believe, as opposed to House and Owen, that it is not sufficient to request a radiograph of the Stenvers type only. This certainly permits us to identify the epitympanum with the ossicles, and it also guides us concerning certain details of the labyrinth; but it leaves formations of great interest to the surgeon without the possibility of examination, such as the styloid process and the walls of the external auditory meatus, which are easily visible in a radiograph of the Mayer type. Nor can we neglect the Schüller projection
GURRIA AB, DEUTSCH L. Congenital Atresia of the Middle and External Ear. AMA Arch Otolaryngol. 1957;65(4):349–355. doi:10.1001/archotol.1957.03830220033004
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