To POP or not: ossiculoplasty in congenital aural atresia surgery.
OBJECTIVE
To examine indications for ossiculoplasty (OP) in aural atresia surgery and to compare audiometric results and surgical revision rates between patients undergoing OP and those undergoing intact native chain reconstruction (INCR).


METHODS
Retrospective chart review.


METHODS
Charts of patients undergoing surgery for congenital aural atresia were reviewed for demographic data, preoperative Jahrsdoerfer score, ossicular chain status, and audiometric data. Patients undergoing OP were compared with an equal number of age and Jahrsdoerfer grade-matched patients who had an INCR. The preoperative and postoperative average air-bone gap (ABG), speech reception thresholds (SRT), and rates of revision surgery were compared between the two groups.


RESULTS
Nineteen patients (20 ears) underwent OP during aural atresia repair and were compared with 20 matched patients who had INCR. Mean age, Jahrsdoerfer score, preoperative ABG, and SRT were similar for both groups. Mean postoperative audiometric follow-up was 33.1 months for the OP group and 20.4 months for the INC group (P = .24). Mean postoperative ABG was 33.8 dB HL for OP and 23.8 dB HL for INCR (P < .05). Mean improvement in ABG was 16.8 dB HL for OP and 29.9 dB HL for INCR (P < .001). Mean improvement in SRT was 24.6 dB HL for OP and 34.8 dB HL for INCR (P < .05). Nine ears (45%) in the OP group and four ears (20%) in the INCR group underwent revision surgery (P = .09).


CONCLUSIONS
Patients reconstructed with their own intact native chain during aural atresia surgery have better audiometric outcomes than those undergoing OP and are less likely to undergo revision surgery.
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Eric J
EJ
Dobratz
Akhil
A
Rastogi
Robert A
RA
Jahrsdoerfer
Bradley W
BW
Kesser
D000293:Adolescent; D002648:Child; D004423:Ear / Q000002:abnormalities*; D004429:Ear Ossicles / Q000002:abnormalities* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006320:Hearing Tests; D006801:Humans; D008297:Male; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement; D019651:Plastic Surgery Procedures; D012086:Reoperation; D016896:Treatment Outcome; D014433:Tympanoplasty