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Atresiaplasty versus BAHA for congenital aural atresia

BACKGROUND For congenital aural atresia, surgical hearing rehabilitation may be accomplished with atresiaplasty or Bone Anchored Hearing Aid (BAHA, Cochlear Americas, Centennial, CO). The Jahrsdoerfer CT grading system has been used to determine which patients are candidates for atresiaplasty. Patients with a Jahrsdoerfer score of 6 or higher are considered to be candidates for atresiaplasty. The higher the grading score, the better the chance for a favorable hearing outcome for atresiaplasty. Hearing results for atresiaplasty range from excellent to fair. BAHA is an alternative to atresiaplasty. Hearing results for BAHA are generally excellent. However, cosmesis is not very good with the BAHA with a visible titanium abutment and snap-on hearing aid, and frequent wound care is required. A decision for BAHA versus atresiaplasty needs to be individualized for each patient because both have advantages, disadvantages, and potential complications.