Congenital aural atresia is characterized by aplasia of the external auditory canal (EAC), often associated with abnormalities of the auricula (microtia), the middle ear, and, occasionally, the inner ear structures. The aim of this study is to evaluate the surgical challenges, complications and long term results of congenital aural atresia(CAA) surgery. Records of 103 patients who underwent surgery because of congenital aural atresia were reviewed between 1992 and 2012 in a tertiary referral center. Audiological and surgical events were observed. Surgical technique, incision type, graft material and long term results were noted. Postoperative visit records and audiograms were investigated. Many types of ossicular chain abnormalities such as absence of an ossicle, deformity of an ossicle or ossicular block were observed. Facial canal dehiscence or abnormal location of the facial nerve was seen in 33.9% of patients. Closure of the air-bone gap (ABG) to 30 dB or less at short-term follow-up occurred in 63.1% of patients. Major complications were as follows: restenosis of the external ear canal, hearing loss, facial paralysis, iatrogenic cholesteatoma and perforation of the graft. The air-bone gap cannot be totally closed in all aural atresias, and there is also the chance of sensorineural type hearing loss. Success of the surgery depends on accompanying abnormalities like unexpected route or dehiscence of facial nerve, status of the ossicular chain and middle ear cleft and surgical techniques. Long term results of congenital aural atresia surgery are encouraging and promising.
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