title: Revision aural atresia surgery: indications and outcomes.
abstract: OBJECTIVE
  To determine the most common indications for revision congenital aural atresia (CAA) surgery and the postoperative healing and hearing outcomes of revision surgery.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Tertiary care academic otologic practice.
  
  
  METHODS
  Patients undergoing revision surgery for CAA.
  
  
  METHODS
  Revision surgery for CAA.
  
  
  METHODS
  Indications for revision atresiaplasty, time to revision surgery, postoperative external auditory canal (EAC) patency, incidence of chronic drainage and/or infection, and postoperative speech reception thresholds (SRTs), and air-bone gaps.
  
  
  RESULTS
  Indications for 75 ears (69 patients) undergoing 107 revision operations for CAA included 58% for EAC stenosis, 19% for chronic drainage and/or infection, and 20% for conductive hearing loss (CHL) alone. Fifty ears (67%) required a single revision. Twenty-five ears (33%) required more than 1 revision. With follow-up longer than 3 months (mean, 41 mo), 69% of ears revised for EAC stenosis achieved a patent canal (29% required >1 revision); 75% of ears revised for chronic drainage and/or infection (mean follow-up, 53 mo) realized a dry canal (22% required >1 revision). For all revision surgeries with adequate follow-up (n = 80), the mean postoperative short-term SRT of 24 dB HL was a significant improvement from the mean preoperative SRT of 39 dB HL (p < 0.01, paired t test).
  
  
  CONCLUSIONS
  EAC stenosis is the most common indication for revision atresiaplasty. Despite the challenges of revision surgery, improvement in canal patency, epithelialization, and hearing utcomes can be achieved.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Oliver
authors.forename: Brian B
authors.initials: BB
authors.lastname: Hughley
authors.forename: David C
authors.initials: DC
authors.lastname: Shonka
authors.forename: Bradley W
authors.initials: BW
authors.lastname: Kesser
mesh_terms: D001299:Audiometry; D002558:Cerebrospinal Fluid Otorrhea / Q000601:surgery*; D003251:Constriction, Pathologic; D004424:Ear Canal / Q000601:surgery; D004427:Ear Diseases / Q000473:pathology / Q000601:surgery*; D005154:Facial Nerve / Q000502:physiology; D005158:Facial Paralysis / Q000209:etiology / Q000503:physiopathology; D006310:Hearing Aids; D034381:Hearing Loss / Q000601:surgery; D016343:Monitoring, Intraoperative; D013506:Otologic Surgical Procedures; D018579:Patient Selection; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation / Q000379:methods; D013067:Speech Perception / Q000502:physiology; D016896:Treatment Outcome; D014433:Tympanoplasty