FOR MANY years otolaryngologists have felt that operative attempts to improve hearing in patients with congenital atresia of the external auditory meatus were of so little value that they advised against surgical treatment. Fraser,1in reviewing the literature, credited Kiesselbach with the first operation that attempted, in 1883, to correct this malformation. Almost every type of surgical procedure has been tried, including radical mastoidectomy with and without skin grafting. Many operations were doomed to failure because the operator did not understand the embryonal development of the condition. This was especially true of attempts to make a new auditory canal without doing any surgical work on the bone. The best results from the standpoint of improvement of hearing were reported by Dean and Gittens2in 1917. They reviewed the various types of operations that had been tried up to that time. They reported that after operation on a patient with