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Comparison of hearing outcomes in patients with congenital aural atresia managed with canaloplasty and bone conduction hearing devices

Abstract Background Treatment options for congenital aural atresia (CAA) include canaloplasty and implantation of an osseointegrated bone conduction device (OBCD). Few studies have compared hearing outcomes in these two treatment methods. Objectives Hearing outcomes and revision surgery rates were compared in CAA patients managed by canaloplasty and surgically implanted OBCD. Methods This study retrospectively analyzed 36 patients with CAA at a single institution. The same surgeon performed canaloplasty on 23 patients. Hearing outcomes before surgery as well as 3 and 6 months after surgery were compared to those of 13 patients with OBCD implantation. Results Postoperative hearing outcomes were better in the OBCD group, but the difference was not statistically significant. At 6-month follow-up, the hearing thresholds in the canaloplasty and OBCD group were 38.6 ± 21.4 and 31.9 ± 6.4 dB, respectively. The success rates 6 months after surgery were 75.0% in the canaloplasty group and 100% in the OBCD group. Two out of 23 patients in the canaloplasty group and 7 out of 13 patients in the OBCD group underwent revision surgery. Conclusion In terms of hearing, the outcome was better with the OBCD compared to canaloplasty. Canaloplasty may be an alternative option in patients who refuse OBCD implantation.