Abstract | OBJECTIVES: 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. STUDY DESIGN AND SETTING: 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. CONCLUSION: 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. SIGNIFICANCE: Refinements in surgical techniques can lead to measurable improvements in outcome in atresiaplasty.
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Authors | Karen Borne Teufert, Antonio De la Cruz |
Journal | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
(Otolaryngol Head Neck Surg)
Vol. 131
Issue 3
Pg. 263-70
(Sep 2004)
ISSN: 0194-5998 [Print] England |
PMID | 15365546
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adolescent
- Adult
- Audiometry, Pure-Tone
- Ear, External
(abnormalities, surgery)
- Female
- Follow-Up Studies
- Humans
- Male
- Postoperative Complications
(epidemiology, etiology, physiopathology)
- Plastic Surgery Procedures
(methods, trends)
- Retrospective Studies
- Time Factors
- Treatment Outcome
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