Management of Congenital Atresia of the External Auditory Meatus: Current Trends

Background and Aim: Congenital aural atresia was described as early as 2000 B.C. The aim of this study is to review the current approaches on the management of congenital atresia of the external auditory meatus.

Materials and Methods: The results of an extensive literature search, including most electronic data bases and medical history books, were used as scientific sources.

Results: The modern imaging techniques, especially high-resolution CT scanning, developed in the 1980s have provided surgeons with accurate anatomic details regarding the middle and inner ear and the mastoid cavity. Jahrsdoerfer in 1992 created a classification system, which is still in use for congenital aural atresia, based on high-resolution CT scan findings of the temporal bone. These developments, as well as improvements in surgery and patient selection, have led to better functional and aesthetic results in the majority of the surgically treated patients. Several refinements in canalplasty, tympanoplasty, and ossiculoplasty for congenital aural atresia have been made since 1980, and large surgical series have been reported by various surgeons. In addition, combined reconstruction of congenital aural atresia and severe microtia, as well as the use of bone-anchored hearing aids and middle-ear transducers, provided a completely new dimension in the rehabilitation of these patients.

Conclusions: Surgery for congenital aural atresia, despite the significant progress, still remains one of the most challenging procedures in otology. Accurate audiological evaluation of the newborns, as well as craniofacial development assessment, is necessary and can help the otologists to choose the proper candidates for surgical repair and proceed to the suitable and age-appropriate therapeutic plan. A close multidisciplinary approach is very important.