A meta-analysis of the long-term hearing outcomes and complications associated with atresiaplasty

Objective: To summarize peer-reviewed literature to evaluate the stability of long-term hearing outcomes with prolonged follow-up, and describe the incidence of complications related to atresiaplasty.

Design: A literature search of EMBASE, MEDLINE, PubMed, Google Scholar, and Web of Science was performed to identify studies of congenital aural atresia (CAA).

Study sample: Selected studies were published between 1997 and 2014. The 19 studies covered 964 CAA ears.

Results: Stenosis and bony regrowth occurred in 14.2% (range from 0% to 30.3%). Lateralization of tympanic membrane (TM) occurred in 7.5% (range from 0% to 18.2%). Facial nerve palsy occurred in 0.5% (range from 0% to 5.0%). Six studies used Air-bone Gap (ABG) to evaluate the short-term and long-term hearing outcomes. The hearing outcomes were performed using meta-analysis, there was no significantly heterogeneity (I(2) = 0%, p = 0.997), and there was a degradation of hearing outcomes with prolonged follow-up (RR = 1.13, 95%CI: 0.98-1.30).

Conclusion: Nearly all studies focus on postoperative stenosis and bony regrowth, but some studies neglect lateralization of TM. Based on available data, which shows a lack of major complications, such as facial nerve palsy, atresiaplasty is a safe procedure. Our meta-analysis indicated that there was a degradation of hearing outcomes with prolonged follow-up.