Congenital aural atresia: Stability of surgical results

Objectives/Hypothesis: To compare early (<1 y) and longer-term (1.0-7.5 y; mean follow-up, 2.8 y) hearing results following surgery for congenital aural atresia and to analyze revision cases for cause of failure, time of occurrence, and outcome. Study Design: Retrospective study of 55 consecutive patients (59 ears) undergoing surgery during an 11-year period for congenital aural atresia, Methods: The best speech reception threshold (SRT) during the first postoperative year was compared with the most recent SRT beyond the first postoperative year. The complication rate and long-term hearing results (>1 y) for initial and revision surgeries were compared. Results: In the early postoperative period, an SRT of less than or equal to 25 dB was achieved in 60% and an SRT of less than or equal to 30 dB in 70%. With longer follow-up (mean, 2.8 y), 46% of patients maintained an SRT less than or equal to 25 dB, Revision surgery was necessary in approximately one third of patients. Longer-term hearing results following initial surgery only or after revision surgery showed an SRT less than or equal to 25 dB in 53% and an SRT less than or equal to 30 dB in 64%, For primary and revisions surgeries the incidence of temporary facial paralysis was 1.5% and for significant hearing loss, 3.0%, Conclusions: Some degradation in hearing does occur as patients are followed beyond the first postoperative year. Revision surgery will be necessary in approximately one third of cases. With revisions, an SRT less than or equal to 25 dB can be expected in half of cases and an SRT less than or equal to 30 dB in two thirds of cases. The ability to provide these hearing results supports this surgery in unilateral cases.