Congenital aural atresia and stenosis: Surgery strategies and long-term results

Abstract

Objective: To compare the patients who underwent surgery for congenital aural atresia (CAA) with congenital aural stenosis (CAS) for the stability of hearing results and complications during long-term follow-up. Design: Retrospective review. Study sample: Seventy-five CAA patients and fifty CAS patients who underwent congenital meatoplasty with canalplasty and tympanoplasty between 2007 and 2012. Results: Paired comparison analyses detected no significant difference in preoperative ABG but significant changes in postoperative ABG, ΔABG, the number of ABG < 30 dB and ABG < 10 dB between CAA and CAS. Complications such as postoperative stenosis, bony regrowth, external aural canal (EAC) infection, EAC eczema, total deaf, and lateralization of the tympanic membrane (TM) were observed in 61.3% of patients with CAA and 20% of patients with CAS. Chi square test detected significant differences in complications between patients with CAA and CAS (χ² = 20.73, p < 0.01). Conclusion: Meatoplasty with canalplasty and tympanoplasty in individuals with CAS can yield reliable and lasting positive hearing results with a low incidence of severe complications. The existence and preoperative condition of patients’ TM and EAC skin helped improve hearing results and decrease the incidence of complications. However, the final hearing results and complications required stricter indications for CAA patients.

Key Words::

• Pediatric
• hearing conservation
• middle ear
• medical audiology

Declaration of interest: The authors declare that they have no conflict of interest.

This work was supported by the Shanghai Health System Talents Training Program (XBR2011068), the Shanghai Science and Technology Committee (12XD1401700), the Third Stage of 985 Project and the Program for Changjiang Scholars and Innovative Research Team in Universities (IRT1010).