D J Trigg1, E L Applebaum. 1. University of Illinois at Chicago, Department of Otolaryngology-Head and Neck Surgery, USA.
Abstract
OBJECTIVE: This study aimed to clarify the indications for elective surgical repair of unilateral aural atresia in children and to review the rates of successful repair in the literature. DATA SOURCES: A search of the published English language literature, 1966-1997, was conducted using the key words aural atresia. STUDY SELECTION: Articles were selected on the basis of their inclusion of the authors' indications for surgical repair of aural atresia or the inclusion of surgical series that showed outcomes. DATA EXTRACTION: Articles reviewed in the review had to either provide specific guidelines for surgical repair of unilateral aural atresia or provide postoperative pure-tone averages, air-bone gaps, or speech reception thresholds. DATA SYNTHESIS: The authors compiled the relevant data into summary tables and extracted conclusions from these data. CONCLUSIONS: Elective surgical repair of unilateral aural atresia should only be attempted in children who meet specific anatomic criteria that predict that they are the most likely to benefit from the results of surgery. Otherwise, repair should be delayed until the age at which the patient can make an informed decision, knowing the risks, benefits, and consequences of this difficult surgery. Parents and surgeons must have a realistic expectation of the surgical results and the practiced benefit to be expected with a normal, contralateral ear.
OBJECTIVE: This study aimed to clarify the indications for elective surgical repair of unilateral aural atresia in children and to review the rates of successful repair in the literature. DATA SOURCES: A search of the published English language literature, 1966-1997, was conducted using the key words aural atresia. STUDY SELECTION: Articles were selected on the basis of their inclusion of the authors' indications for surgical repair of aural atresia or the inclusion of surgical series that showed outcomes. DATA EXTRACTION: Articles reviewed in the review had to either provide specific guidelines for surgical repair of unilateral aural atresia or provide postoperative pure-tone averages, air-bone gaps, or speech reception thresholds. DATA SYNTHESIS: The authors compiled the relevant data into summary tables and extracted conclusions from these data. CONCLUSIONS: Elective surgical repair of unilateral aural atresia should only be attempted in children who meet specific anatomic criteria that predict that they are the most likely to benefit from the results of surgery. Otherwise, repair should be delayed until the age at which the patient can make an informed decision, knowing the risks, benefits, and consequences of this difficult surgery. Parents and surgeons must have a realistic expectation of the surgical results and the practiced benefit to be expected with a normal, contralateral ear.