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Congenital aural atresia: Stability of surgical results
Author(s) -
Lambert Paul R.
Publication year - 1998
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199812000-00007
Subject(s) - medicine , surgery , atresia , retrospective cohort study , incidence (geometry) , complication , physics , optics
Objectives/Hypothesis : To compare early (<1 y) and longer‐term (1.0–7.5 y; mean follow‐up, 2.8 y) hearing results following surgery for congenital aural atresia and to analyze revision cases for cause of failure, time of occurrence, and outcome. Study Design : Retrospective study of 55 consecutive patients (59 ears) undergoing surgery during an 11‐year period for congenital aural atresia. Methods : The best speech reception threshold (SRT) during the first postoperative year was compared with the most recent SRT beyond the first postoperative year. The complication rate and long‐term hearing results (>1 y) for initial and revision surgeries were compared. Results : In the early postoperative period, an SRT of ≤25 dB was achieved in 60% and an SRT of ≤30 dB in 70%. With longer follow‐up (mean, 2.8 y), 46% of patients maintained an SRT ±25 dB. Revision surgery was necessary in approximately one third of patients. Longer‐term hearing results following initial surgery only or after revision surgery showed an SRT ±25 dB in 53% and an SRT ±30 dB in 64%. For primary and revisions surgeries the incidence of temporary facial paralysis was 1.5% and for significant hearing loss, 3.0%. Conclusions : Some degradation in hearing does occur as patients are followed beyond the first postoperative year. Revision surgery will be necessary in approximately one third of cases. With revisions, an SRT ±25 dB can be expected in half of cases and an SRT ±30 dB in two thirds of cases. The ability to provide these hearing results supports this surgery in unilateral cases.