Surgical treatment of congentital aural atresia

Objective To investigate the clinical characters of congentital aural atresia and the surgical treatment of the disease. Methods In this series, 64 ears with congentital aural atresia operated on in our hospital during the period from January 1999 to December 2003 were restrospectively analysed. Results Forty-one of these ears were surgically corrected by anterior approach, the remaining 23 were corrected by transmastoid approach. Of all cases, the tympanic cavity was encountered without difficulty in 61 ears except for 3 ears. Ossicular chain anomalies occurred in all these 61 ears, and varying degrees of abnormal facial nerve were found in 40 ears ( 65.57% ). Postoperative follow-up ranged from 1 to 5 years. The hearing improvement was observed in 49 ears( 80.33% ), of which 32 ears had hearing improvement greater than 30 dB and the air-bone conduction gap was within 15 dB( 52.46% ). The external auditory stenosis occurred in 6 of these ears during the priod from postoperative 3 months to 2 years, of which 4 ears obtained goood results after the second operation. Lateralization of the tympanic membrane presented in 2 ears and infections of the cavity in other 2 ears. Facial paralysis occurred postoperatively in 3 ears, which recovered 2 to 6 months later. Conclusions The surgical procedures had no regular pattern, depending upon what one sees during the operation. The sclerotic and diploetic atretic bone could be indications for superoanterior surgical approach, whereas it would be wiser for the mixed and pneumatic mastoid to be corrected by transmastoid approach.