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Children with congenital atresia of the external auditory canal require an early assessment of hearing and a determination of the degree of atresia and associated pathology by polytomography and/or high‐resolution CT scanning. We analyzed the otologic findings in 302 ears (239 patients) with severe atresia of the external auditory canal. Eighty‐seven primary or revision surgeries were performed. Fifty‐three percent obtained a residual conductive deficit of 20 dB or less. Lateralization of the tympanic membrane graft was the primary cause of failure in obtaining good hearing results. The use of split‐thickness skin graft instead of a full‐thickness skin graft to cover the reconstructed external canal has decreased the incidence of restenosis and revision surgery.

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