Two-step external ear canal construction in atresia as part of auricular reconstruction.

Abstract

One of the common complications of atresia surgery is restenosis of the surgically constructed external ear canal. To avoid this complication, a new two-step technique of creating an external ear canal was developed and evaluated. Prospective clinical evaluation. Thirty-six patients with third-degree microtia and aural atresia have been treated this way. In the first step, the canal is drilled into the petrous bone, a Silastic cylinder is inserted and wrapped into pieces of cartilage and bone dust. In the second step several months later, the implant is removed and a slightly smaller tube covered with a split thickness skin graft is inserted. Except the first three patients operated with a slightly different technique, none of the following 33 patients showed a severe restenosis. Instead, all had a nice, smooth external ear canal. With this two-step technique of creating a new external ear canal in atresia, we could avoid one of the major complications of this kind of surgery. The external ear canal is either necessary for the reconstructed middle ear or it can be used to adapt a (behind or in the ear) hearing aid. By integrating this technique into a three-step concept for auricular reconstruction, the patient does not need any additional operation, and his or her rehabilitation from ear malformation can be enhanced.