Canaloplasty is corrective surgery for congenital aural atresia (CAA), and this surgery aims to provide patients with serviceable hearing by restoring the sound-conducting mechanism of the ear and creating a patent, well-epithelialized external auditory canal. The author performed more than 350 cases of canaloplasty until recently and the surgical procedures and outcomes in terms of hearing, sound localization, speech understanding in noise and appearance scale were introduced.
Hearing improved to within 30 dB of air-bone gap in 58% at long-term follow-up. Sound localization ability improved at 6 months and the SSQ questionnaire also showed improvement in spatial domain. Hearing in noise test revealed that signal-to-noise ratio (SNR) improved when the noise comes from the newly-opened atretic ear or from the normal ear as well, which means a restoration of binaural processing. Analysis of an appearance scale shows that canaloplasty has positive aesthetic effects on the appearance of the ear and can effectively reduce related distress. Postoperative stenosis can effectively be prevented by application of a long-term stent.
Canaloplasty is a safe, effective method for restoring hearing and binaural advantages, and should be considered as a first management option for patients with CAA.