Atresiaplasty or Canalplasty
The word “atresia” means lack of an ear canal. Almost all patients born with microtia also have atresia. Before the advent of bone-anchored hearing processors, there were not that many options to correct the hearing loss in a child with microtia and atresia. During that time, the first option was to leave the ear without hearing correction. The second option was to surgically open the ear canal, a procedure called “atresioplasty”. Atresiaplasty is a very complex surgery performed.
Atresiaplasty or Canalplasty Procedure
Before an atresiaplasty is recommended, a high-resolution CT scan of the temporal bone is performed. There are various grading classifications to determine if a child is a candidate for ear canal surgery. The main factors in determining if a child is a candidate for this type of surgery are:
- Middle ear and mastoid pneumatization
- Anatomy of the ossicles (middle ear bones)
- Inner ear morphology
- Course of the facial nerve
Some potential complications from atresiaplasty are:
- Ear canal stenosis or narrowing from scar tissue
- Tympanic membrane lateralization or migration of the eardrum outwards
- Chronic infection
- Facial nerve injury – This injury should be rare because of excellent intra-operative facial nerve monitoring equipment
- Sensorineural hearing loss – Permanent hearing loss to the inner ear organ
It is very important to consult with an experienced neurotologic surgeon to discuss the risks and benefits of this type of surgery.