Aural atresia refers to the absence an external ear canal. When someone has aural atresia, there is a high incidence of malformation of the external ear and middle ear also, but the inner ear and auditory nerve are frequently normal. It is important not to forget the "normal" ear in patients who have one-sided Atresia as approximately 25% of these individuals may have a hearing loss in their best side also.

A narrowed ear canal (i.e. one where the eardrum can be viewed, but the canal is narrower than normal) is sometimes referred to as a stenotic canal, or canal stenosis. Aural atresia most commonly effects just one ear (unilateral aural atresia), but can occur both ears (bilateral aural atresia). Atresia is most frequently isolated, but can be a symptom of a larger syndrome, such as Treacher Collins, Goldenhar, Crouzon's, Alpert's, Pfeiffer, Klippel-Feil, BOR (Branchio-Oto-Renal) also known as Melnick-Fraser, 18-q chromosome, as well as Hemifacial Microsomia.

The surgery to create a normal sized ear canal from either a stenotic canal or complete aural atresia is known as an "atresia repair" and is sometimes also referred to as a canalplasty.

Aural Atresia / Canal Stenosis Repair

Microtia (meaning 'Small ear') is a congenital deformity of the outer ear. Over 90 % of the time, microtia is unilateral, meaning only one ear is affected, but it can also be bilateral, affecting both ears. Boys are affected more than girls, and in unilateral microtia, the right side is affected more than the left. Microtia occurrence in the general population is approximately one in 8,000 globally, but ranges wildly depending on ethnic group in question -- from less than one in 1000 in some indigenous groups in Mexico, the US and South America, to one in 2100 in the Japanese/Korean community, to 1 in 20,000 in the overall Caucasian community.

Grade III is most common, and can be corrected by surgery.

Costs for atresia repair surgery are highly variable and depends on the complexity of the surgery and the patient's insurer. There are three sources of billing for atresia repair surgery, they are:

In the United States, insurers will inform you what they will pay for surgery based on CPT codes. The CPT codes most commonly used in conjunction with atresia repair are:

After the patient has returned home, they will need to continue follow-up care with a qualified ENT. These arrangements should actually be made before the atresia repair surgery, as the post-surgery follow-up appointments may be difficult to schedule in a timely manner if the initial contact with the local ENT is made after the surgery has been completed.

The first visit to the local ENT will be approximately 1 to 2 weeks after the final post-operative visit at CEI. At this visit, the doctor needs to remove the last of the gelfoam in the ear canal. The second visit to the local ENT should be 2 to 4 weeks after the first visit, and a microscopic cleaning should be performed to remove any additional debris. A hearing test can be performed after the second visit to the local ENT. Additional hearing tests should be performed at three month intervals during the first year of post operative care, more frequently if behavioral concerns or physical symptoms warrant it.

The newly created ear canal needs to be cleaned by an ENT using a microscope at regular intervals that generally once or twice a year. If the patient has any other chronic medical conditions or additional surgeries, the cleanings may need to be more frequent as this will cause wax (known as "cerumen") production to increase. California Ear Institute physicians work with other ENTs around the world for detailed post-operative follow-up. Only if serious complications arise will a patient have to return to our facility.