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:

  1. Middle ear and mastoid pneumatization
  2. Anatomy of the ossicles (middle ear bones)
  3. Inner ear morphology
  4. Course of the facial nerve

Some potential complications from atresiaplasty are:

  1. Ear canal stenosis or narrowing from scar tissue
  2. Tympanic membrane lateralization or migration of the eardrum outwards
  3. Chronic infection
  4. Facial nerve injury – This injury should be rare because of excellent intra-operative facial nerve monitoring equipment
  5. 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.