Unexplained Variation in Benefit of Treatment of Congenital Unilateral Aural Atresia: A Review of the Literature

Abstract

<b><i>Objective:</i></b> A review of published data regarding binaural hearing after treatment of congenital unilateral conductive hearing loss (UCHL) due to aural atresia. Treatment options concern atresia surgery (reconstructive surgery), application of a bone conduction device (BCD), or application of a middle ear implant (MEI). <b><i>Data Sources:</i></b> Database PubMed was searched for articles published in English and German between January 1, 1994, and January 1, 2019. <b><i>Study Selection:</i></b> The initial search identified 52 studies, of which 9 met the inclusion criteria. <b><i>Data Synthesis:</i></b> Comparison of studies was based on a structured review. Meta-analysis was not feasible because of the heterogeneity of outcome measures, the limited number of relevant papers (9), and diverse types of treatment (5). <b><i>Conclusions:</i></b> Treatment of UCHL results in bilateral hearing instead of binaural hearing. The large intersubject variability in benefit of treatment is unexplained with a clear improvement in the minority of listeners and a limited improvement or binaural interference in most listeners after atresia repair or amplification with a BCD or MEI.