Congenital Aural Atresia and Microtia

What are congenital aural atresia and microtia?

Congenital aural atresia is a common condition. It happens when the ear canal does not develop normally. Atresia can be in one ear (unilateral) or both (bilateral). It is often part of microtia, a condition when the outside of the ear (pinna) does not form correctly.

Treatment for congenital aural atresia and microtia

Below are our general recommendations for treatment for children with congenital aural atresia and microtia. The Children’s Hearing Center team will customize your child’s treatment to meet your child’s individual needs.

  • A child with unilateral atresia should:
    • Not rely solely on a newborn hearing screening. An audiologist should perform a complete hearing assessment for your child at birth. 
    • Have regular follow up evaluations with an audiologist to
      • Monitor communication skills
      • Determine if a speech and language evaluation is required
    • Be watched closely for ear infections. These may cause delays in speech and language skills
  • A child with bilateral atresia should:


Surgery can often be performed on children who have unilateral or bilateral atresia. Your child must be at least 5 years old to undergo surgery.

First, a computed tomography (CT) scan will be performed to make sure that the middle and inner portions of the ear are developed enough to allow surgery to be performed.

Next, a surgeon first repairs the microtia, if necessary. After that heals, an ear surgeon (otologist) creates an ear canal and eardrum to improve hearing. This is called an atresia repair. A small skin graft from the thigh or hip is usually needed to line the new ear canal.

Learn more about the operating rooms and how to help prepare your child for surgery >

After treatment

Follow-up visits to the ear surgeon are required every six to 12 months to clean out the ear canal. Earplugs may be needed while bathing or swimming to prevent infections.

Some children may need to wear a hearing aid in the operated ear.

Congenital aural atresia and microtia surgery outcomes

Hearing results for children with atresia are good. Many children can hear on the telephone and notice an improvement in identifying the direction from which sounds are coming. While many children have near-normal hearing, completely normal hearing should not be expected.