Long-term Audiometric Outcomes After Atresiaplasty for Congenital Aural Atresia

Long-term Audiometric Outcomes After Atresiaplasty for Congenital Aural Atresia: Objective:

Describe long-term trends and stability of hearing outcomes for patients undergoing primary congenital aural atresia (CAA) repair.

Study Design:

Retrospective chart review.

Setting:

Single academic, tertiary referral center.

Patients:

Children and adults who underwent primary CAA repair between 1980 and 2017.

Intervention:

CAA repair.

Main Outcome Measures:

Long-term (> 1 yr) postoperative three-tone (500, 1000, 2000 Hz) air conduction pure-tone average (AC PTA) compared with the immediate (within 90 d of surgery) postoperative audiogram.

Results:

The mean preoperative AC PTA was 59.6 dB HL. CAA repair improved hearing an average of 30.5 dB, but hearing declined by 8.2 dB over the long-term follow-up period (mean 4.4 yr; range 1–15.7 yr), leaving a final mean improvement of 22.2 dB (final mean AC PTA 37.3 dB HL). Two-thirds (92 of 138 ears) had an AC PTA ≤ 30 dB HL recorded in the first year after surgery. At the last follow-up test, 64% had “stable” hearing defined as no more than a 10 dB decline in AC PTA compared with the immediate postoperative audiogram; 21% had a 10 to 20 dB decline, 8% a 20 to 30 dB decline, and 7% declined > 30 dB.

Conclusions:

All patients enjoyed improvement in AC PTA after surgery (preoperative minus the best postoperative PTA, mean = 34 dB, range = 3.3–52 dB). Hearing declined by an average 8.2 dB over the long-term leaving a final average AC PTA of 37.4 dB HL. Sixty-four percent of patients exhibited stable (