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Congenital Aural Atresia

1. Computed tomography. Axial view. 2. Well formed auricle.
3. Postauricular incision. Preparation of the mastoid cortex. 4. The cribriform area of the mastoid cortex.
5. Collection of bone paste for occlusion of mastoid cells. 6. Drilling starts in the cribriform area.
7. The attic becomes visible. 8. Entrance to the attic.
9. Drilling away bone reveals the short crus of the incus (at the end of the needle). 10. Drilling away the atretic plate reveals the body of the incus.
11. The fused malleus-incus complex. 12. Creation of the external aperture of the new ear canal.
13. Large mastoid air cells are plugged with bone paste. 14. Tympanoplasty with the use of temporal fascia.
15. Insertion of the split-thickness skin graft. 16. The skin graft in its final position.
17. Insertion of a silastic button. 18. Obliteration of the new ear canal with pieces of gelfoam.
19. The lateral edges of the skin graft are folded over the gelfoam packing. 20. Suturing of the skin graft with the new aperture of the auricle.