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Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.

Auditory Canal Atresia or Stenosis

Auditory canal atresia is a developmental absence of the external auditory canal. It is often associated with microtia (a poorly developed outer ear). One ear is typically affected, but both ears can be atretic. Patients with atresia often have other developmental abnormalities of the external ear and middle ear, resulting in conductive hearing loss – hearing loss that arises from abnormal transmission of sound through the outer and/or middle ear. The inner ears and auditory nerves may be normal.

Auditory canal stenosis refers to narrowing of the ear canal(s). This can also be associated with external and middle ear malformations. Patients with auditory canal stenosis are at high risk for ear canal cholesteatoma formation. Therefore, temporal bone imaging studies may be required to ensure that this is not happening.

Auditory canal atresia is congenital (present at birth) while stenosis can be congenital or acquired. Congenital atresia/stenosis may be associated with several different syndromes, including Treacher Collins, Goldenhar, Klippel-Feil, Branchio-Oto-Renal (BOR), and Hemifacial Microsomia. Acquired stenosis is unusual but is usually associated with infection, chronic inflammation, trauma, radiation therapy, or poor ear canal healing after surgery.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist recruited to Southern Arizona.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped to optimize delivery of personalized ear and lateral skull base care.
  • Dr. Jacob offers several surgical options to treat auditory canal atresia/stenosis. First, a high-resolution temporal bone CT scan is obtained to determine extent of external and middle ear development. Based on imaging results, some patients may be candidates for canalplasty (atresia repair). The goals of that operation are to restore the external auditory canal to its normal size and improve sound conduction. An alternative approach in patients with normal or near-normal inner ear function is the use of bone anchored hearing implants (BAHI). Such implants deliver sound directly to the cochlea by way of bone conduction, by-passing the external ear completely. VORP (Vibrating Ossicular Prosthesis), which is a middle ear implant, is a third option. VORP transforms sound into mechanical energy that is directly transferred to the middle ear bones, round window, or oval window. A digital external amplification system, programmed by an audiologist, is required.