Diagnosis and management strategies in congenital atresia of the external auditory canal

Citation
F. Declau et al., Diagnosis and management strategies in congenital atresia of the external auditory canal, BR J AUDIOL, 33(5), 1999, pp. 313-327
Citations number
83
Categorie Soggetti
Otolaryngology,"da verificare
Journal title
BRITISH JOURNAL OF AUDIOLOGY
ISSN journal
03005364 → ACNP
Volume
33
Issue
5
Year of publication
1999
Pages
313 - 327
Database
ISI
SICI code
0300-5364(199910)33:5<313:DAMSIC>2.0.ZU;2-I
Abstract
This consensus report represents a distillation of current opinion regardin g diagnosis and management of congenital aural atresia. It also takes into account the philosophical differences which exist in Europe. Congenital aur al atresia requires prompt diagnosis, genetic counselling and an early asse ssment of hearing. In bilateral atresia, early amplification with a bone co nduction hearing aid is essential for proper speech development. Further re habilitation in bilateral cases is managed with surgical reconstruction in selected patients or by implantation of a bone-anchored hearing aid. Atresi a repair surgery is worthwhile if proper patient selection is made by use o f stringent audiological and radiological criteria and state of the art sur gery is performed. The divergent views concerning indications, ideal age fo r surgery and surgical approach to achieve better hearing are discussed. Re view of the literature demonstrated that even in the hands of the best surg eons a mean hearing gain of only 20-25 dB is achieved in atresia Type II, w ith 30-35 dB in Type I. Therefore, surgical reconstruction should only be d one in the more favourable cases where post-operative hearing of <25-30 dB is attainable. Less favoured patients should be helped with bone-anchored h earing aids, as this type of surgery does not interfere with the future use of new techniques.