Long-term Outcomes of Surgical Intervention for Symptomatic Aural Atresia and Stenosis

Abstract

Abstract Background This study aims to analyze the clinic features of symptomatic aural atresia and stenosis, and to explore the surgical techniques and postoperative care for aural atresia and stenosis. Methods A retrospective analysis on 24 patients with aural atresia (nine patients) or stenosis (15 patients) was conducted. They had done surgery and followed over one years. The basic information, etiologies, symptoms, with or without cholesteatoma were collected. For preventing postoperative restenosis, a plastic sheet with expansive sponge was commonly used as support material. And triamcinolone acetonide was locally injected when a stenotic tendency occurred. Additionally, three representative cases are presented. Results The main symptoms were hearing loss, otorrhea and otalgia. Cholesteatoma appeared in 10 patients (66.7%, 10/15) with aural stenosis and six patients (66.7%, 6/9) with aural atresia. After surgery intervention, the air-bone gaps (ABG) in both stenosis and atresia group significantly improved. Restenosis was observed in two patients (8.3%, 2/24) with aural stenosis. The etiologies of them were congenital and acquired, respectively. Tympanic membrane (TM) lateralization occurred in one patient (4.2%, 1/24) with aural atresia. Intralesional injection of triamcinolone acetonide was performed in two patients. One received injection three times and obtained a satisfying outcome. However, the other one failed to continue this treatment and restenosis occurred. Conclusion Surgical intervention is a gold standard for symptomatic aural stenosis and aural atresia. To achieve a promising outcome, a plastic sheet with expansive sponge was helpful to support the new EAC and a regular follow-up was mandatory. When a restenosis tendency occurred, intralesional injection of triamcinolone acetonide might benefit to improve it.