Aural Atresia Guidelines

Updated: Apr 29, 2022
  • Author: Bradley W Kesser, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Guidelines Summary

International Microtia and Atresia Workgroup

Consensus recommendations on the treatment of total congenital aural atresia (CAA), published in 2019 by the International Microtia and Atresia Workgroup (IMAW), include the following [57] :

  • Bone-conduction technology for children with bilateral aural atresia is very strongly recommended to support speech and language development
  • Evaluation of the temporal bones using careful computed tomography (CT) scanning is recommended, as is precise assessment of the type of hearing loss and of preoperative motivation with the softband
  • To prevent the processor from interfering with microtia reconstruction, a discussion between the otolaryngologist/otologist/pediatric otolaryngologist and microtia surgeon regarding placement of the osseointegrated bone conduction hearing device is strongly recommended
  • It is recommended that children over age 6 years whose hearing and anatomy support surgical reconstruction (ie, those with normal inner ear function and a Jahrsdoerfer score of 7 or higher) undergo atresia surgery with the understanding that revision surgery may be required if the canal and hearing are compromised by new bone growth during puberty
  • It is strongly recommended that atresia repair be performed in combination with or subsequent to autologous rib graft microtia repair and prior to porous polyethylene microtia repair