Clinical Aspects of Congenital Aural Atresia. Canaloplasty and Tympanoplasty.:-Canaloplasty and Tympanoplasty-

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The Authors describe 8 years of experience with the surgical management of 31 ears with complete and 6 ears with incomplete congenital aural atresia.Canaloplasty was performed in 18 ears and tympanoplasty in 19 ears. In this series there were 28 males and 6 females, aged 5 to 44 years at the time of surgery.Surgical attempts to improve hearing were tried in all 37 ears but failed in 18 because of inability to reach the tympanic cavity by interruption of surgery due to profuse bleeding, leakage of liquor, damage to the capsule of the temporomandibular joint, etc.The success rate was 27.8% with canaloplasty and 84.2% with tympanoplasty, based on postoperative average hearing levels of 35dB or less for 0.5, 1 and 2kHz. The final success rate with tympanoplasty was 63.2% based on the average hearing levels at the last examination. The average follow-up period was 2.5 years for tympanoplasty cases.The results led to the following conclusions:1. Stenosis of the reconstructed external auditory canal was prevented by creation of a canal with at least 1.5 times the normal diameter.2. The presence of a mobile stapedial footplate results in satisfactory hearing improvement in most cases of middle ear anomaly, especially when tympanoplasty is performed.3. Lateralization of the reconstructed tympanic membrane is the primary cause of hearing loss following initial improvement.
耳鼻咽喉科臨床学会の論文