Surgical management of congenital aural atresia

ABSTRACT

A prospective study was done on 11 pediatric patients with congenital aural atresia [CAA] with or without macrotia of the ear. The use of early audiological evaluation [using auditory brain stem response [ABR] and pure tone audiometry] and strict radiologic and clinical criteria for surgical candidates was necessary. The surgical reconstruction of their congenital aural atresia was reviewed for hearing improvement, cosmetic improvement, safe ear and complications. The aim of the surgery was to create a patent skin lined external auditory canal and improvement of hearing threshold. Functional hearing was obtained in 54% of cases with safe ear. Congenital cholesteatoma was found in two ears. The split thickness skin graft was associated with minimal complications. The main complications were recurrent infection [45%], stenosis of the canal [36%], failed graft [27%] and keloid of the wound [18%]. Though, the improvement of postoperative results for CAA requires an experienced otologic surgeon, long-term follow up together with control of infection through strict asepsis. Also, improved personal hygiene is mandatory