gms | German Medical Science

Introduction: External auditory canal atresia is a rare congenital disorder which affects one or both ears. With a conductive haring loss of 60 dB, even unilateral atresia affects hearing related social skills. Reconstruction surgery is difficult and hazardous and functional results may be insufficient thus making bone-conduction hearing aids the first-line therapy nowadays.

Methods: Two 6-year-old children with unilateral cartilaginous and bony external auditory canal atresia were enrolled. Investigation involved physical examination, pure-tone and speech audiometry, and high-resolution computed tomography with three dimensional reconstructions. Reconstruction surgery from retroauricular approach comprised maximal enlargement of the tympanic and mastoid cavities while the facial nerve canal was preserved. The cavities were closed with an adapted conchal cartilage, the medial part of which was made thinner to serve as a tympanic membrane.

Results: Postoperative period and facial nerve function were normal. Hearing improvement reached the level above the social threshold, with which the subjects were absolutely satisfied. The reconstructed auditory canal remained stable and widely patent during the follow-up period of 1 year.

Conclusion: The authors highlight that surgical reconstruction of the external auditory canal is safe and effective and involves reasonably short surgical time. Stable audiological benefits improve patients’ satisfaction and quality of life without the necessity of hearing aids. The procedure is essentially assisted by careful preoperative imaging techniques and intraoperative facial nerve monitoring. Further improvement in hearing levels can be reached in a second sit by thinning down and readapting the conchal cartilage which serves as a tympanic membrane.

Supported by: clinical associates

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