Two-stage aural atresia and stenosis surgery with the use of synthetic skin substitute

Abstract

Conclusion. With this technique, patency rates achieved in congenital external ear canal (EAC) atresia/stenosis and improvement in hearing were evaluated as 'good' and 'satisfactory', respectively. Objectives. We aimed to test the efficacy of a novel two-stage technique in preventing restenosis following atresioplasty. Patients and methods. Nine patients with congenital EAC atresia/stenosis comprised our cases. We performed 10 atresioplasties using the two-stage technique described below. In the first stage, the ear canal is drilled and its wall is covered with a synthetic skin replacement that induces proliferation of a soft tissue; in the second stage this is lined underneath with split thickness skin graft. Operations were complemented with tympanoplasties in five of the patients. Results. Nine (91%) of 10 operations carried out with the technique were largely successful in terms of patency. The achieved average hearing gain was air conduction/bone conduction (Ac/Bc): 31.33/9.44 dBHL (21.89 in the air-bone gap), while the postoperative air-bone conduction gap was changed to <30 dBHL in eight (88.9%) of the patients.