title: Advances in congenital aural atresia surgery: effects on outcome.
abstract: OBJECTIVE
  To compare modifications in the surgical technique of congenital aural atresia (use of argon laser, thinner split-thickness skin graft, Silastic sheets in the external auditory canal, and Merocel wicks) by examining hearing results and complications before and after initiation of these changes.
  
  
  METHODS
  Retrospective chart review of patients who underwent congenital aural atresiaplasty between 1985 and 2002 in a tertiary referral neurotologic private practice. Complication rates and hearing results were compared before (n = 36) and after (n = 80) modifications in the surgical technique.
  
  
  RESULTS
  Closure of the air-bone gap to 30 dB or less at short-term follow-up occurred in 63.1% of surgeries performed after modifications in the surgical technique and 44.5% of surgeries performed before these changes. The long-term postoperative air-bone gap was 30 dB or less in 50.0% of the surgeries performed after and 47.1% of the cases performed before the changes in surgical technique. Soft tissue stenosis and bony growth of the external auditory canal were seen in 3.8% of surgeries performed after and 13.9% of surgeries performed before the surgical technique changes. Ossicular chain refixation occurred in 3.8% of surgeries performed after and 25.0% of surgeries performed before such changes. There were no dead ears and no facial palsies.
  
  
  CONCLUSIONS
  The use of argon laser, thinner split-thickness skin graft, Silastic sheets in the external auditory canal, and Merocel wicks, as a group, has helped to improve hearing results and decrease the incidence of complications in congenital aural atresia surgery.
  
  
  CONCLUSIONS
  Refinements in surgical techniques can lead to measurable improvements in outcome in atresiaplasty.
authors.affiliation: House Ear Institute, Los Angeles, California, USA.
authors.forename: Karen Borne
authors.initials: KB
authors.lastname: Teufert
authors.forename: Antonio
authors.initials: A
authors.lastname: De la Cruz
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D004431:Ear, External / Q000002:abnormalities* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D019651:Plastic Surgery Procedures / Q000379:methods / Q000639:trends; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome