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Pediatric External Auditory Canal Atresia (EAC)

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Summary

External auditory canal atresia (EAC atresia) is a condition where the ear canal fails to develop. 

Expanded Overview

EAC is typically discovered at birth during the newborn examination, but occurs during the first trimester. A genetic cause has been identified in some patients. EAC atresia is a feature of several syndromes including:

Testing and Diagnosis

Patients with EAC atresia are typically referred by their primary care doctor to an otolaryngologist (ENT specialist). A complete history and physical exam typically reveals microtia and atresia. A CT scan is often obtained once a child is 3 to 4 years old to evaluate the patient’s temporal bone anatomy.

Treatment

Atresiaplasty (canaloplasty) involves the creation of a new ear canal and ear drum with possible reconstruction of the ear bones. This procedure is performed no sooner than 4 to 5 years of age unless a patient has bilateral atresia. Management of the new ear canal after surgery can be challenging in younger patients secondary to cooperation issues. 

Most plastic surgeons prefer to address the malformed external ear prior to performing an atresiaplasty. Performing an atresiaplasty prior to repairing the external ear is sometimes preferred by plastic surgeons who use an implant as opposed to rib cartilage

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