Audiometric Outcomes After Surgical Repair of Congenital Aural Atresia: Does Age Matter?

Objective To determine if there is an age-based difference in audiometric outcomes for patients undergoing primary congenital aural atresia (CAA) repair. Study Design Retrospective chart review. Setting Single academic, high-volume, tertiary care hospital. Patients Individuals undergoing primary CAA repair by a single surgeon between 2004 and 2020. Intervention(s) CAA repair. Main Outcome Measure(s) Preoperative and postoperative four tone (500, 1,000, 2,000, 4,000 Hz) air-conduction pure-tone average (PTA), bone-conduction PTA, air-bone gap and speech reception threshold, and preoperative to postoperative change in values. Results We identified 247 patients (262 ears) who underwent repair. The mean and median ages were approximately 12 and 8.5 years, respectively, both of which served as cutoff ages to compare younger versus older patients. The average preoperative to postoperative improvement values in air-conduction PTA, air-bone gap, and speech reception threshold for individuals younger than 12 years were 26.6 +/- 10.2, 23.8 +/- 12.6, and 30.1 +/- 12.1 dB hearing level (HL), respectively, and those for individuals 12 years or older were 25.9 +/- 15.7, 26.2 +/- 10.3, and 31.3 +/- 12.8 dB HL, respectively. For individuals younger than 8.5 years, the values were 25.8 +/- 9.5, 24.9 +/- 9.4, and 30.0 +/- 10.6 dB HL, respectively, and those for individuals 8.5 years or older were 27.1 +/- 13.5, 25.7 +/- 11.0, and 30.0 +/- 14.6 dB HL, respectively. The improvement did not differ significantly between the younger and older groups, using both cutoff ages. There was no difference in revision surgery rates or complications between groups. Conclusion An individual at any age can enjoy audiometric improvement from atresia repair.