Auricula Anomalies and Auricula Atresia

The external auditory canal (EAC) and middle ear components do not fully mature in congenital aural atresia (CAA). The ear canal and middle ear embryonic development can be halted at any stage. Consequently, the severity of this deformity might fluctuate, which can be challenging for the clinician. In extreme cases, the ear canal is not discernible (total atresia), and the middle ear and its components (ossicles or ear bones) are either completely missing or severely underdeveloped. A shallow blind pouch may form at the end of the ear canal if there is any sign of an external auditory meatus (outer opening). A stenotic (narrow) ear canal, a tiny hole that leads into the middle ear canal, and even a primitive tympanic membrane can be seen in milder cases. The ossicular chain, which connects the tympanic membrane to the ear bones, might or might not be present in these ears. One of the most challenging procedures an ear specialist encounters is surgery to fix CAA. A surgically lined external auditory canal free of debris and moisture is one of the primary aims of the procedure, along with the patient’s permanent hearing loss reduction or improvement. Additionally challenging for surgical reconstruction is the presence of microtia, also known as “small ear,” or inadequate development of the auricle (pinna), which is a common complication of CAA.