Acquired medial canal fibrosis

Abstract

Acquired medial canal fibrosis is a discrete clinicopathological entity characterized by formation of fibrous tissue in the bony external auditory meatus.Over a seven-year period, a total of 14 operative procedures were performed on 12 ears involving 10 patients. Four cases had followed otitis externa, two were complications of suppurative otitis media, and three cases were iatrogenic. The cause could not be identified in three ears involving two patients.Treatment entails excision of all the fibrous tissue and involved skin, a wide canaloplasty, a meatoplasty, and then reconstruction by split skin graft. Two cases of canal cholesteatoma were encountered. Average follow-up of two years showed hearing improvement in all patients. The only complication was a recurrence of the stenosis in two ears. The paper discusses terminology, aetiology, pathophysiology, diagnosis, and principles of treatment of this condition.

Medial Canal Fibrosis: Surgical Technique, Results, and a Proposed Grading System

“…The causes to which this condition has been attributed have ranged from chronic infections and inflammation (3) to previous surgery or trauma (7). In our experience, all our patients developed this condition from chronic infections secondary to self-induced trauma (e.g., cotton swab usage).…”

Postinflammatory medial meatal fibrosis: early and late surgical outcomes

“…This was noted in El-Sayed's series, in which blunting of the angle was considered to be an early form of restenosis. 13 Similarly, Tos and Balle note the tympanomeatal angle as an important anatomical point from which fibrous tissue should be thoroughly removed in order to prevent restenosis. 1 Complete removal of the fibrous tissue inevitably results in large areas of denuded bone.…”

External Auditory Canal Stenosis After Radiation Therapy

“…External auditory canal stenosis may be caused by many insults, including trauma, surgery, and infection. 12,13 The common denominator is a fibroproliferative inflammatory response. Such a response is typical of EBRT with all normal tissues, 14 as well as the EAC.…”