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Published on: January 25, 2016
Audiometric Outcomes After Surgical Repair of Congenital Aural Atresia: Does Age Matter?
Rachel H Jonas1, Geoffrey C Casazza2, Bradley W Kesser1
1Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia.
Insights
Age does not affect hearing improvement after congenital aural atresia (CAA) repair. Both younger and older patients achieve similar audiometric outcomes and complication rates following primary CAA surgery.
Area of Science:
- Otolaryngology
- Audiology
- Pediatric Surgery
Background:
- Congenital aural atresia (CAA) is a condition that affects hearing development.
- Surgical repair aims to improve audiometric outcomes.
- The impact of patient age on surgical success in CAA repair requires further investigation.
Purpose of the Study:
- To evaluate if age influences audiometric outcomes in patients undergoing primary congenital aural atresia repair.
- To compare hearing improvements between younger and older patient cohorts.
Main Methods:
- Retrospective chart review of 247 patients (262 ears) who underwent primary CAA repair between 2004 and 2020.
- Audiometric outcomes including air-conduction PTA, bone-conduction PTA, air-bone gap, and speech reception threshold were analyzed.
- Patients were stratified into younger and older groups using cutoff ages of 12 years and 8.5 years.
Main Results:
- No significant difference in preoperative to postoperative improvement in air-conduction PTA, air-bone gap, or speech reception threshold was observed between younger and older patient groups, using both 12-year and 8.5-year cutoff ages.
- Average hearing improvements ranged from 23.8 to 31.3 dB HL across all groups.
- Revision surgery rates and complication rates were comparable between age groups.
Conclusions:
- Congenital aural atresia repair offers significant audiometric improvement regardless of patient age.
- The findings suggest that age is not a limiting factor for successful hearing outcomes in CAA repair.
- Both younger and older individuals can benefit from surgical intervention for CAA.
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.
Interventions:
CAA repair.
Main Outcome Measures:
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.
