Hazards in surgery, such as facial nerve damage, membranous labyrinthitis, postoperative canal stenosis, infections, and induced sensory neural hearing loss caused by transmission of drill vibration, have been prevented by routine use of CT scan and facial nerve monitoring. ![]() The benefits from the surgery must exceed the risks largely. Correction of aural atresia is known, as one of the most difficult otologic surgery. Either audiometric or ABR must be performed to establish cochlear function and imaging of temporal bone must be done to assess the inner ear. In addition to the grading system, another factor is the timing of surgery depending on the age of the patient better at the age of 4 or 5 years for better mastoid pneumatization but early bone surgery on one ear at 2 years of age is advised in bilateral cases, unilateral atresiaplasty is typically postponed until 15–16 years of age, but we prefer to do so sooner despite intact contralateral hearing, as these patients have difficulties in communication and academic performance. These scales form the cornerstone for picking up the perfect patients for surgical correction of CAA. The atresia have cosmetically and functional impact on the patients, which is related to the disorder degree (partial or complete) or the extent (unilateral or bilateral).CAA have different grading system, the most applied one is The Jahrsdoerfer grading scale, which is based on preoperative CT scan and appearance of the auricle. This is the basis for repair of aural atresia. On embryological bases, the inner ear is usually normal. Aural atresia mostly affect the right side, osseous more than membranous, and is found in male more than female 3-5 times. Congenital aural atresia may be isolated, a part of syndrome, or chromosomal aberration. The condition is associated with microtia. Proper alignment and soft-tissue strategies are keys to the effective correction of the congenitally atretic ear canal.Īural atresia is a rare condition present at birth, which was estimated to be 1:10,000 to 1:20,000. The previous approach, due to fewer postoperative complications, is now our favorite technique. ConclusionsĪlthough the findings of the hearing are close. Five cases had postoperative otorrhea, one in the anterior mastoid group and four in the transmastoid group. Lateralization of the graft was seen in one patient in the transmastoid group, and no ossicular chain refixation. TM perforation was seen in two patients (12.51%), one patient in each group. There were no cases of bony canal stenosis. Four patients (25%) developed soft tissue meatal stenosis, with 2 patients in each group. ResultsĪll patients were satisfied with the surgery by improving the hearing up to 35 dB or less after 12 months. Purpose of the study was to compare hearing effects and risks of anterior and transmastoid approaches to external and middle ear restoration in patients with CAA. Postoperatively, patients were tested for hearing recovery and follow-up lasting up to 2 years to record any complications. Ten patients had bilateral atresia, and 6 had unilateral atresia. The study consisted of 16 patients, 8 patients for each group, 10 males and 6 females between 4 and 18 years of age with a median age of 6 years. A retrospective study of 16 cases of CAA was undertaken in the Hearing and Speech Institute between 20. This article describes the writers’ expertise with surgical management of aural atresia. Many surgeons are doubtful to perform a repair due to poor hearing results and the risk of new canal stenosis. Surgical procedures of CAA is not only difficult but has still not been embraced by surgeons. Aural atresia (CAA) is a congenital abnormality with hypoplasia or aplasia of the external auditory canal.
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