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Aural Atresia/Microtia

Introduction

Atresia repair is the surgical procedure to correct congenital aural atresia which is ear reconstruction surgery. We have performed 60-100 successful atresia repair surgeries per year on children and adults with unilateral as well as bilateral atresia, creating functional ear canals and restoring hearing to within normal limits through ear reconstruction surgery.

 

Treatments

Atresia Repair surgery or a ear reconstruction surgery is to create a normal sized ear canal from either a stenotic canal or complete aural atresia is known as an “atresia repair” and is sometimes also referred to as a canaloplasty. To improve hearing, tympanoplasty (creating ear drum) and ossiculoplasty (rearrange hearing bones) are done.

Aural Atresia_Microtia_image 1

So far canaloplasty has been done after otoplasty. But we recommend hearing improvement surgery should be done early as three years of age, so that hearing can be maximized during the crucial language development burst that takes place between the ages of three and five. Our clinic developed minimum invasive canaloplasty (star shaped incision), so otoplasty can be performed after canaloplasty.

On the other hands, in case of patients who have severe malformations, we recommend a special type of hearing aid called BAHA (bone anchored hearing aid).

Aural Atresia_Microtia_image 2

 

Candidate for the Treatment

Step 1: CT Scan

-Scans should be done in all children over age 21/2 solely for the purposes of atresia repair assessment.

-Atresia repair candidacy is scored from a CT scan on a scale between 1 and 10, loosely corresponding to the chance that hearing within normal range (i.e. an score of 8 represents an 80% chance of restoring hearing to below 25 dB).

-Scores of 8, 9, or 10 Atresia repair is commended Scores of 6 or 7 Atresia repair is possible. Scores of 0 to 5 Atresia repair is generally not recommended, unless there is concurrent sensorineural hearing loss and the need to wear traditional hearing aids is essential to restore hearing.

-If the patient is not a good atresia repair candidate, then the BAHA (Bone Anchored Hearing Appliance) device is also option for patient over age 5. The BAHA device can be worn on a headband for children under age 5.

 

Step 2: Audiogram

-A comprehensive air/bone audiogram is helpful in determining whether or not a patient is a good atresia repair candidate. For children under 18 months of age, this is best done through a sedated ABR examination. For children 18 months to 3 years of age, conditioned play or visually reinforced audiomtry can generally be performed.

 

Step 3: Medical Consultation

-If you already have a CT scan, we will review it for you free of charge and let you know whether it is good enough to determine atresia repair candidacy, or if another scan with very specific parameters are required. Scans (either film or CD) should be mailed along with the radiology report and a recent audiogram to our clinic.

-surgery + admission for 6 days

Postoperative care : visit twice (one month & 3 month after surgery)

 

Before and After Photo:

Aural Atresia_Microtia_Before & After

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