Congenital auditory meatal atresia: a numerical review.

Congenital auditory meatal atresia (CAMA) is an uncommonly encountered disorder. Though a rare condition, CAMA poses multiple problems for affected children. Recent management of CAMA in developed countries rests on osseo-integrated prostheses and bone-anchored hearing aids. The situation is different in developing countries where aesthetic and otologic surgeries are the available lines of management. Surgical management of CAMA has been staged into reconstructive surgery for auricular deformity followed by external and middle ear reconstruction either via anterior or transmastoid approaches. Multiple case series describing the outcomes and complications of both approaches have been published, but no authors have attempted to compare either. We have attempted to compare the outcomes and complications of both approaches by analyzing published medical articles concerning surgical management of CAMA identified by searching the Medline database using "congenital aural atresia" and "external auditory canal atresia" as keywords. A total of 923 ears were reported by 13 articles included in this study. The transmastoid approach is shown, by multiple linear regression, to have better postoperative hearing gain and less likely restenosis.