Results of tympanoplasty for congenital aural atresia and stenosis, with special reference to fascia and homograft as the graft material of the tympanic membrane.

The surgical management of congenital aural atresia is a challenging, complex procedure, and the risks are great. The otologic surgeon is responsible for keeping a patent external auditory canal and for achieving satisfactory hearing. The present report studied hearing changes that occurred after tympanoplasty and the long-term results of tympanoplasty in 12 cases of congenital aural atresia or stenosis. Patients were followed for more than 2 years after surgery. In four ears, an allograft of the tympanic membrane with an attached malleus was used, with a good graft take and hearing results. An autograft of temporal fascia was used in eight ears. Hearing acuity decreased in six of the eight ears and was maintained in two ears. Three primary surgery patients required revision surgery for postoperative restenosis of the external auditory canal. Some comments have been made with regard to this problem. Emphasis is also placed on the selection of patients for surgery using a thorough audiologic and roentgenologic evaluation.