Reconstructive procedures for congenital aural atresia.

The three surgical methods currently in use to improve hearing for patients with congenital aural atresia are fenestration of the lateral semicircular canal, canal plasty, and type III tympanoplasty. Because the surgery is difficult and the functional rewards are modest, it should ordinarily be reserved for patients with bilateral atresia. Of the 12 ears operated by the technique of type III tympanoplasty, the average gain in hearing was 22 dB, with seven attaining a 30 dB or better air-conduction threshold. When aural rehabilitative and cosmetic surgery are contemplated, coordinated planning by the surgeons is necessary to acquire the best end result.