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Ear malformations with hearing impairment Name: Date of Birth: MRN Number: Family Number: Phenotype Present Phenotype Description Cochlear aplasia Hypoplasia of the cochlea Incomplete partition of the cochlea type I Incomplete partition of the cochlea type II Abnormality of the internal auditory canal Absent internal auditory canal Dilated internal auditory canal Narrow internal auditory canal Abnormality of the cochlear nerve Abnormality of the vestibular nerve Aplasia of the semicircular canal Hypoplasia of the semicircular canal Enlarged semicircular canal Morphological abnormality of the anterior semicircular canal Morphological abnormality of the lateral semicircular canal Morphological abnormality of the posterior semicircular canal Aplasia of the vestibular nerve Aplasia of the vestibule Dilated vestibule of the inner ear Hypoplasia of the vestibule of the inner ear Enlarged vestibular aqueduct Abnormality of the middle ear ossicles Abnormality of the incus Abnormality of the malleus Absent malleus Abnormality of the stapes Absent stapes head Osteosclerosis Stapes ankylosis Congenital stapes ankylosis Aplasia of the middle ear ossicles Fusion of middle ear ossicles Conductive hearing impairment Sensorineural hearing impairment Unknown Yes No Ear malformations with hearing impairment ADDITIONAL PHENOTYPING Phenotype Description Phenotype Present Unknown Yes No