Abdel-Aziz Mosaad
Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Craniofac Surg. 2013 Jul;24(4):e418-22. doi: 10.1097/SCS.0b013e3182942d11.
Congenital aural atresia is a spectrum of ear deformities present at birth that involves some degree of failure of the development of the external auditory canal. This malformation may be associated with other congenital anomalies; it occurs as a result of abnormal development of the first and second branchial arches and the first branchial cleft and most often occurs sporadically, although the disease may be manifested in different syndromes. Congenital aural atresia is considered one of the most difficult and challenging surgeries for the otologic surgeon. The goals of atresia surgery are to restore functional hearing, preferably without the requirement of a hearing aid, and to reconstruct a patent, infection-free external auditory canal. The repair is usually done at the age of 6 years, so children with bilateral atresia may need hearing amplification in the first few weeks of life until the age at surgery. To optimize the surgical outcome, careful audiological and radiological evaluation of the patient should be performed preoperatively. Also, postoperative frequent packing and regular follow-up are mandatory to avoid restenosis and infection of the newly created canal. With careful intraoperative dissection and regular follow-up, complications of surgery can be avoided.
先天性外耳道闭锁是一种出生时就存在的耳部畸形，涉及外耳道发育在某种程度上的失败。这种畸形可能与其他先天性异常有关；它是由于第一和第二鳃弓以及第一鳃裂发育异常所致，并且最常散发出现，尽管该疾病可能在不同综合征中表现出来。先天性外耳道闭锁被认为是耳科医生最困难且最具挑战性的手术之一。外耳道闭锁手术的目标是恢复功能性听力，最好无需助听器，并重建一个通畅、无感染的外耳道。修复手术通常在6岁时进行，因此双侧闭锁的儿童在出生后的头几周可能需要听力放大，直到手术年龄。为了优化手术效果，术前应对患者进行仔细的听力学和放射学评估。此外，术后频繁填塞和定期随访对于避免新造耳道的再狭窄和感染是必不可少的。通过仔细的术中解剖和定期随访，可以避免手术并发症。
