In the last 20 years 89 middle ear operations were performed on 71 patients with unilateral or bilateral microtia (grade II or III). The methods and the results are described and discussed. In 79.5% we produced a wide auditory canal and achieved an overall hearing gain of 17 dB. We usually do not carry out middle ear surgery in unilateral atresia. In bilateral atresia the child is fitted with a bone conduction hearing aid as soon as possible and is operated on at the age of 4 or 5 years. After middle ear surgery we reconstruct the auricle at an age of 5 or 6 years. If necessary these children are then fitted with an air conduction hearing aid.
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