Long term results of postoperative canal stenosis in congenital aural atresia surgery.
CONCLUSIONS
Benefits of the use of anteriorly and inferiorly based periosteal flaps (AIPFs) in congenital aural atresia (CAA) patients was found to be effective at reducing canal stenosis (CS) occurrence by long term F/U. However, in terms of minimizing CS, in addition to recruitment of AIPFs, considerations of patient factors, such as degree of microtia and age are mandatory.


OBJECTIVE
AIPF during canaloplasty were evaluated with a specific focus on whether this technique can offset the negative effects of several risk factors for postoperative CS after CAA surgery.


METHODS
The authors undertook a retrospective review of the medical records of 164 congenital aural atresia patients (190 ears) who had undergone surgery at Seoul National University Hospital. Median follow up period was 54 months. The anterior approach surgical method with and without the use of AIPFs were utilized in 111 and 79 ears respectively. Comparison of the influences of several factors on CS occurrence was undertaken by statistical analyses to evaluate whether this AIPFs technique can counterbalance the negative effect of patient factors in postoperative CS.


RESULTS
Those with a younger age (<12 yrs), moderate to severe microtia (grade II, III), or those in whom AIPF was not used in surgery (non AIPF group) were found to show statistically significant higher frequency of CS(+). Nevertheless, the positive effect of AIPF was not able to completely counterbalance the effects of negative patient factors on CS development. A protocol compatible with the results of this study that minimizes CS is presented in the discussion.
Chang
Sun O
SO
Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea. suno@snu.ac.kr
Lee
Jun Ho
JH
Choi
Byung Yoon
BY
Song
Jae-Jin
JJ
D000367:Age Factors; D002648:Child; D003251:Constriction, Pathologic / Q000209:etiology / Q000517:prevention & control; D004423:Ear / Q000002:abnormalities* / Q000601:surgery*; D004427:Ear Diseases / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D010521:Periosteum / Q000637:transplantation; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps