The divergent views concerning indications, ideal age for surgery, and surgical approach to achieve better hearing illustrate the complexity of cases of congenital aural atresia. Whether the anomaly is unilateral or bilateral also influences the criteria on which the surgical decision is based. In the thirty-six ears operated on between 1972 and 1983 using the canal plasty technique, the average hearing gain was 20 dB, with 18 ears having an air conduction threshold of 35 dB or better after a long follow-up.