Surgical Treatment Of Congenital Acoustic Atresia

Objectives:To investigate the operation method,the prevention of complications, the surgical effect of congenital aural atresia,make the diagnosis and treatment is more reasonable and standardized.Methods:39patients (43ears) underwent operation between1991and2012were retrospectively investigated. The43ears were divided into two groups according to the appearance of the external ear. The first group consisted of32ears with auricle malformation and atresia of the external auditory meatus, the second group consisted of11ears with abnormal external auditory meatus (no atresia) and auricle malformation. The auricle deformity were divided into three degrees according the classification put forward by Marx. The method of surgery were summarized,5ears were only underwent external auditory canal reconstruction,4ears were underwent external auditory canal reconstruction and atticotomy, and the remaining34ears were underwent external auditory canal and middle ear reconstruction.Results:All patients were followed up ranged from0.5to1.5years except for five people (all of them were unilateral patients). The external auditory stenosis and atresia occurred in9(23.68%) of these ears during the period from postoperative4months to8months that need a revision surgery, of which8ears had been operated (the remaining one reject the secondary operation), all ears obtained good results. Lateralization of the tympanic membrane was presented in3ears, the improvement of hearing is not ideal, all refused the reoperation due to the other ear having practical hearing. The cavity infections and otorrhea was found in5ears. Facial paralysis was occurred postoperatively in3people (all of them were unilateral patients), which recovered1to3months later with medical treatment. Half a year after operation, the hearing improvement were found over20dB in19ears (50.00%), of which7ears (18.42%) had hearing improvement greater than30dB, only1ear (2.63%) were found over40dB, and not found sensorineural hearing loss.Conclusions:1. Surgery is the effective treatment of congenital aural atresia, its effect can be influenced by the degree of ear deformity, operation method and postoperative complications.2. There are three keys to raise the curative effect:giving a detailed assessment of hearing level and imaging examination, choosing the best way to reconstruct the tympanic cavity, preventing complications.3. Using self-skin split graft, maintenance of width of the external acoustic meatus, expand the new external auditory canal for appropriate time and so on are the keys to avoid the external auditory canal restenosis after surgery.4.External auditory canal atresia or stenosis and auricula abnormality have no obvious correlation, the results of this study is different from other literature reports, may be the number of samples is not enough.