Aural Atresia
When the inside of a child’s ear doesn’t completely form, it’s called aural atresia. Often, this shows up with differences in the appearance of their outer ear as well (called microtia). These problems can affect both ears (bilateral) or only one (unilateral).
Aural atresia involves the:
- Ear canal (absent)
- Eardrum (usually absent)
- Middle ear (smaller)
- Ear bones (underdeveloped or not formed normally)
At UVA Health Children’s, we are one of the only pediatric ENT programs with the ability to surgically correct this condition. With surgery, most patients with atresia can regain normal or near-normal hearing. We also offer many treatment options for children too young for surgery or with middle ear anatomy that makes surgery not a good option.
Aural Atresia Diagnosis
The newborn hearing screen is an important part of newborn care. Often, this test helps us identify aural atresia early. Aural atresia is almost always accompanied by microtia (“small ear”) so the condition is identified early in the infant’s life. Special hearing testing can help us understand the status of the child’s hearing in both ears.
When your child is older, we can conduct a CT scan if you wish. This will help us understand your child’s middle and inner ear structures and help us determine if your child is a candidate for surgery to open the ear canal and improve hearing.
When Should We Schedule My Child’s CT Scan?
We usually recommend waiting until your child is 5-6 years old. That way, we can see how the ear bone grows and the anatomy of the middle and inner ear structures.
Treatment for Aural Atresia
For your baby’s healthy development, we’ll work to restore their hearing. This helps with language and speech development.
Sometimes, when only one ear is affected by atresia, the other ear is able to do the work of both.
Bone Anchored Hearing Aid
Because aural atresia mainly affects the middle ear, a bone-conducting hearing device can improve hearing significantly. And unlike a cochlear implant, it won’t affect your child’s existing hearing or prevent them from getting aural atresia surgery later.
Aural Atresia Surgery
Creating an ear canal and outer ear can restore normal hearing, but only if your child is a good candidate. We’ll work with you to find out if this is something your child may benefit from. We don’t perform this surgery until a child is older, around 6-7.
Speech & Language Therapy
Because hearing loss can slow language development, we’ll help you set up care with a speech-language pathologist. They can help your child with speaking and making sense of the sounds they hear.
What Causes Aural Atresia?
Aural atresia is a very rare condition, and we don’t know what causes it. Rarely, it’s linked to a genetic condition. If we think that may be the case for you, we can help you with genetic testing.
Microtia
Often, children born with aural atresia will also have microtia. That means that the external part of their ear (“auricle” or “pinna”) is small or even missing. Surgery can build an outer ear, but this operation (or operations) is separate from aural atresia surgery and involves different surgeons.