Revision aural atresia surgery: indications and outcomes.

Abstract

OBJECTIVE:

To determine the most common indications for revision congenital aural atresia (CAA) surgery and the postoperative healing and hearing outcomes of revision surgery.

STUDY DESIGN:

Retrospective case review.

SETTING:

Tertiary care academic otologic practice.

PATIENTS:

Patients undergoing revision surgery for CAA.

INTERVENTION:

Revision surgery for CAA.

MAIN OUTCOME MEASURES:

Indications for revision atresiaplasty, time to revision surgery, postoperative external auditory canal (EAC) patency, incidence of chronic drainage and/or infection, and postoperative speech reception thresholds (SRTs), and air-bone gaps.

RESULTS:

Indications for 75 ears (69 patients) undergoing 107 revision operations for CAA included 58% for EAC stenosis, 19% for chronic drainage and/or infection, and 20% for conductive hearing loss (CHL) alone. Fifty ears (67%) required a single revision. Twenty-five ears (33%) required more than 1 revision. With follow-up longer than 3 months (mean, 41 mo), 69% of ears revised for EAC stenosis achieved a patent canal (29% required >1 revision); 75% of ears revised for chronic drainage and/or infection (mean follow-up, 53 mo) realized a dry canal (22% required >1 revision). For all revision surgeries with adequate follow-up (n = 80), the mean postoperative short-term SRT of 24 dB HL was a significant improvement from the mean preoperative SRT of 39 dB HL (p < 0.01, paired t test).

CONCLUSION:

EAC stenosis is the most common indication for revision atresiaplasty. Despite the challenges of revision surgery, improvement in canal patency, epithelialization, and hearing utcomes can be achieved.

• Authors: Eric R Oliver, Brian B Hughley, David C Shonka, Bradley W Kesser
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 32 Issue 2 Pg. 252-8 (Feb 2011) ISSN: 1537-4505 [Electronic] United States
• PMID: 21178807 (Publication Type: Journal Article)

Topics

• Audiometry
• Cerebrospinal Fluid Otorrhea (surgery)
• Constriction, Pathologic
• Ear Canal (surgery)
• Ear Diseases (pathology, surgery)
• Facial Nerve (physiology)
• Facial Paralysis (etiology, physiopathology)
• Hearing Aids
• Hearing Loss (surgery)
• Monitoring, Intraoperative
• Otologic Surgical Procedures
• Patient Selection
• Postoperative Complications (physiopathology, prevention & control)
• Reoperation
• Retrospective Studies
• Risk Assessment
• Skin Transplantation (methods)
• Speech Perception (physiology)
• Treatment Outcome
• Tympanoplasty