Analysis of the long-term hearing results after the surgical repair of aural atresia.
OBJECTIVE
Careful surgical candidate selection guarantees a high probability of serviceable hearing postoperatively in congenital aural atresia (CAA) patients. The authors analyzed hearing results after CAA surgery with long-term follow-up (F/U) with respect to several clinical factors.


METHODS
This was a retrospective study.


METHODS
The medical records of 93 CAA patients (100 ears) who underwent operations from January 1987 through December 2002 at Seoul National University Hospital were reviewed. Mean duration was 56.9 months. The authors evaluated the results of hearing after surgery over 3 year F/U with a view to clarifying the factors accounting for unsuccessful results.


RESULTS
Approximately 64% of patients treated surgically achieved a considerable hearing gain over long-term F/U. Postoperative hearing remained relatively stable over the period from 6 months to 3 years postoperatively, yielding only 2.75 dB of aggravation. However, hearing results in revision cases deteriorated with time, which led to statistically higher air-conduction thresholds than those of primary cases at the 1 and 3 year F/Us. Resultantly, only 26.6% of patients having achieved a poor hearing gain post first surgery benefited from revision audiologically. The severity of microtia was found to help predict poor long-term hearing outcomes after CAA surgery.


CONCLUSIONS
Nonrevision cases and cases with mild microtia appear to have acceptable and stable long-term hearing results. Disappointing long-term hearing results in revision, and severe microtia cases should lead to considerations of alternative options in these cases, such as bone-anchored hearing aids, which offer reliable and stable results.
Chang
Sun O
SO
Department of Otolaryngology, Seoul National University National University Hospital, Seoul, Korea.
Choi
Byung Yoon
BY
Hur
Dong Gu
DG
D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D001844:Bone Conduction / Q000502:physiology; D002648:Child; D004424:Ear Canal / Q000002:abnormalities* / Q000601:surgery; D004431:Ear, External / Q000002:abnormalities* / Q000601:surgery; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology*; D006311:Hearing Disorders / Q000151:congenital* / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D009998:Ossicular Prosthesis; D012086:Reoperation; D012189:Retrospective Studies; D016038:Skin Transplantation; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods