Controversies in aural atresia repair.

PURPOSE OF REVIEW: To discuss recent controversies regarding the management of aural atresia.

RECENT FINDINGS: Management of unilateral atresia is less controversial. Candidacy for successful repair is based on high-resolution computed tomography findings and atresia grading. The bone-anchored hearing aid is a viable alternative strategy for hearing improvement. Stability of hearing results following atresia repair improves with the number of atresiaplasties performed. Development of image-guided surgery may provide benefit in atresia surgery. New unrecognized rare complications of aural atresia and atresia repair including salivary fistula and middle ear cholesteatoma are now being recognized and are manageable.

SUMMARY: Management of aural atresia continues to be difficult and surrounded by controversy. New studies and cases series may shed light on these management issues.