Surgical treatment of congenital aural atresia - is it still justified?

Acta Otolaryngol. 2015 Mar;135(3):226-32. doi: 10.3109/00016489.2014.979437. Epub 2015 Jan 27.

Abstract

Conclusion: Surgery candidacy based on the surgical accessibility of the middle ear seems more valuable than the use of a preoperative grading system. Also patients with severe malformations can benefit from surgical reconstruction.

Objective: To evaluate the long-term results of the primary surgical treatment of patients with congenital auricular atresia (CAA).

Methods: One hundred patients with CAA underwent surgical reconstruction between 1985 and 2010. The mean follow-up time was 40 months. All patients were retrospectively scored using the Jahrsdoerfer grading scale and divided into two groups according to the grade of their malformation. Group 1 included 20 patients with scores of 4-6 and group 2 included 80 patients with scores of 7-10. Pre- and postoperative air conduction (AC), bone conduction (BC), pure-tone average 'air-bone gap' (PTA₄-ABG), surgical findings, postoperative complications, and revision surgeries performed were determined and compared between the two groups.

Results: For 90% of the patients in group 1 and 79% of the patients in group 2, the postoperative ABG was within 0 and 30 dB. The most common complications were recurrent infection, lateralization of the tympanic membrane, and restenosis of the ear canal.

Keywords: atresiaplasty; grade of malformation; long-term results.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Congenital Abnormalities / epidemiology
  • Congenital Abnormalities / surgery*
  • Ear / abnormalities*
  • Ear / surgery
  • Hearing Tests
  • Humans
  • Middle Aged
  • Otologic Surgical Procedures / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Prognosis
  • Reoperation
  • Retrospective Studies
  • Severity of Illness Index
  • Sweden / epidemiology
  • Treatment Outcome
  • Young Adult

Supplementary concepts

  • Aural Atresia, Congenital