[Analysis of surgical reconstructions of canal and middle ear via "direct entrance" approach in 53 ears with congenital aural atresia].
OBJECTIVE
To recognize the indication of surgical reconstruction via the "direct entrance" surgical approach (superoanterior surgical approach) for congenital atresia of the external acoustic canal and malformations of the middle ear.


METHODS
A series of 53 ears operated on via the superoanterior surgical approach during 10 years from January 1988 to December 1997 was analyzed.


RESULTS
The tympanic cavity was encountered without difficulty in 52 ears. Facial paralysis occurred postoperatively in one ear, which recovered after two months. The hearing improvement was observed in 45 ears (84.9%), of which 24 ears had hearing improvement greater than 30 dB and the air-bone conduction gap was within 15 dB (45.3%). A long-term (1-9 years) follow-up of 25 ears demonstrated that the hearing levels in 18 ears were kept unchanged. Postoperative stenosis of the canal occurred in one ear of a 2 years-old child.


CONCLUSIONS
Based on the scanning images of the temporal bone by high-resolution computed tomography before the operation, the authors classified the bony structures of the paths of external acoustic canals into four types. Our results indicated that the selerotic and the diploetic paths of external acoustic cmeati could be indications for the "direct entrance" surgical approach, whereas the mixed type, either containing a little small cells or diploetic bone in sclerotic bone, might be suitable for this surgical approach also.
Wang
J
J
Department of Otorhinolaryngology Union Hospital, Tongji Medical University, Wuhan 430022.
Yu
Q
Q
Kong
W
W
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004431:Ear, External / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D004432:Ear, Middle / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*