Treatment of Aural Atresia (CAA)
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Meatal atresia is the condition where the ear canal is narrowed for some reason. This condition can be either acquired or congenital. Ear canal connects the external ear with the middle ear and the rest of the ear structures. It is important for normal functioning of the hearing. When ear canal narrows, the person may experience decrease in hearing and also have some problems with normal production of ear wax. Ear wax filtrates all bad components that get into the ear, such as dirt, chemicals or water. Earwax is important for efflux of all unnecessary elements from the ear canal.
Meatal atresia is a very rare condition which can develop as a result of congenital abnormalities of the middle ear and also when the child is born with the ear deformity, such as microtia. Microtia is a condition when the ear is too small. In rare cases the ear can be absent altogether and then the ear canal can be narrowed as a result of that.
According to statics, meatal atresia is diagnosed in 1 child out of ten thousand. Genetic predisposition and also genetic mutation can lead to development of meatal atresia. Problems during pregnancy, such as acute and severe viral and bacterial infections, can affect normal development of ear in the child.
Meatal atresia is slightly more common in boys than in girls. Also, meatal atresia is 3 times more common in only one ear, so this condition is predominantly unilateral. In such case, another ear functions normally and the child can hear all the sounds normally because one ear compensates the hearing problem of another. In 11-17% of all meatal atresia cases the child also has sensorineural hearing loss.
- Ear deformity which could be noticed almost immediately after the birth of the child
- Narrowed hearing canal can also be seen
- Abnormalities in other structures of the face can be present in some cases as well, if meatal atresia was caused by genetic mutation which affected other parts of the body as well
- Problems with hearing and, in some cases, speaking when the child grows up
- During a general examination, the doctor will examine the ear canal of the baby to determine if it is narrowed.
- Otoscopy is the procedure which usually allows the doctor to determine the extent of narrowing and also determine the type of ear deformity if it is present.
- An audiogram assesses the hearing of both ears by sending sound waves to the ear canal through the headphones. This is a very accurate diagnostic method which allows to see if the hearing of a child is normal.
- A CT scan, MRI and an X-ray help to determine extent of meatal atresia and see if this narrowing blocks the hearing and also ear wax from exiting the ear.
- Surgical treatment is used to widen the ear canal and also improve the hearing of a child.
- Timing is very important in performing the surgery. You will need to consult with your doctor to determine the best time to have the surgery and also how to achieve hearing improvement, if it is decreased.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed