MANAGEMENT OF CONGENITAL ATRESIA OF THE EXTERNAL AUDITORY-CANAL

The management of a unilateral congenital atresia of the external audi tory canal is nonuniform and debated. Various surgical approaches, tim ing, coordination with microtia repair, and variable hearing improveme nts all contribute to the debate regarding management of this entity. This paper outlines our craniofacial team approach to the congenital u nilateral atresia and microtia in children, Selection criteria, timing of repair, coordination with microtia repair, surgical results, and p itfalls will be discussed, The results of surgery in 16 patients with unilateral congenital atresia of the external auditory canal and 2 chi ldren with bilateral atresia will be presented, Repair of the atresia was undertaken in children 5 years or older who had pneumatized mastoi ds and middle ears, Replacement of the malleus/incus complex with a pa rtial ossicular reconstruction prosthesis improved closure of the air- bone gap, Drawbacks included meatal stenosis and deepithelization of t he split thickness skin graft lining the external auditory canal, Repa ir of the unilateral congenital atresia is a demanding and challenging problem but one in which excellent results are achievable.