69320 Reconstruction external auditory canal for congenital atresia, single stage

Name of the Procedure:

Reconstruction of the External Auditory Canal for Congenital Atresia, Single Stage

Summary

In this procedure, a surgeon reconstructs the ear canal for patients born without one or with a severely narrowed canal, a condition known as congenital atresia. The procedure helps to improve hearing and the appearance of the ear in a single surgical session.

Purpose

This surgery addresses congenital atresia of the ear canal, a condition where the ear canal is absent or severely underdeveloped. The primary goals are to create an open ear canal to improve hearing and to cosmetically enhance the appearance of the ear.

Indications

• Congenital atresia (absence or severe narrowing of the external auditory canal)
• Moderate to severe conductive hearing loss due to atresia
• Functional and cosmetic concerns arising from the condition

Preparation

• The patient may need to fast for a specific period before the surgery.
• A thorough hearing test and imaging studies like CT scans to assess the ear anatomy.
• Blood tests and a preoperative physical examination.
• Discussing any current medications with the surgical team for possible adjustments.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made behind the ear to access the affected area.
3. The surgeon carefully dissects and removes bone and tissue to form a new ear canal.
4. A skin graft, often taken from another part of the body, is used to line the newly created canal.
5. The external ear structure may be adjusted to improve cosmetic appearance.
6. Finally, the surgical site is closed with sutures and a temporary packing is placed in the new canal.

Duration

The surgery typically takes between 3 to 5 hours.

Setting

This procedure is usually performed in a hospital or a specialized surgical center.

Personnel

• Otolaryngologist (ENT surgeon)
• Anesthesiologist
• Surgical nurses
• Audiologist (for preoperative assessment)

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma
• Canal restenosis (narrowing of the canal again)
• Temporary or permanent facial nerve injury
• Hearing improvement might be less than expected

Benefits

• Improved hearing, often noticeable shortly after recovery.
• Enhanced cosmetic appearance of the ear.
• Reduction of recurrent ear infections associated with the malformed canal.

Recovery

• Hospital stay for 1-2 days post-surgery.
• Pain management with prescribed medications.
• Keeping the surgical site dry and clean.
• Regular follow-up appointments to monitor healing.
• Avoiding strenuous activities and swimming for several weeks.
• Full recovery typically spans several weeks to a few months.

Alternatives

• Bone-anchored hearing aids (BAHAs) as a non-surgical hearing improvement option.
• Reconstructive surgery in multiple stages rather than a single stage.
• Using a prosthetic ear pinna for cosmetic improvement only.

Patient Experience

During the procedure, patients will be under general anesthesia and will not experience any pain. Post-operatively, they may feel some discomfort and pain around the surgical site, which can be managed with pain relief medications. The initial packing in the ear might cause temporary hearing difficulties until it is removed. With proper care and rest, most patients gradually return to normal activities.