Management of Acquired Atresia of the External Auditory Canal

Abstract

OBJECTIVE:The aim was to evaluate surgical techniques and their relationship to postoperative success rate and hearing outcomes in acquired atresia of the external auditory canal. MATERIALS and METHODS:In this article, 24 patients with acquired atresia of the external auditory canal were retrospectively evaluated regarding their canal status, hearing, and postoperative success. RESULTS:Acquired stenosis occurs more commonly in males with a male: female ratio of 2-3:1; it seems to be a disorder affecting young adults. Previous ear surgery (13 patients, 54.2%) and external ear trauma (11 patients, 45.8%) were the main etiological factors of acquired ear canal stenosis. Mastoidectomy (12/13) and traffic accidents (8/11) comprise the majority of these etiological factors. Endaural incision is performed in 79.2% and postauricular incision for 20.8% of cases during the operation. As types of surgical approach, transcanal (70.8%), transmastoid (20.8%), and combined (8.4%) approaches are chosen. The atretic plate is generally located at the bony-cartilaginous junction (37.5%) and in the cartilaginous canal (33.3%); the bony canal is involved in a few cases only. Preserved healthy canal skin, split-or full-thickness skin grafts, or pre-or postauricular skin flaps are used to line the ear canal, but preserved healthy canal skin is preferred. CONCLUSION:The results of surgery are generally satisfactory, and complications are few if surgical principles are followed.

Otologic considerations in a full face transplant recipient

“…Advanced stenosis can lead to chronic otitis externa, accumulation of cerumen, or hearing impairment . Relief from these symptoms may be managed with meatoplasties, with the goal of restoring a wide meatus and preserving native canal skin to ensure cerumen migration . Restenosis is possible, although rates are typically low .…”

“…15 Relief from these symptoms may be managed with meatoplasties, with the goal of restoring a wide meatus and preserving native canal skin to ensure cerumen migration. 16 Restenosis is possible, although rates are typically low. 15,17 More aggressive cartilaginous resection was considered during the initial meatoplasties; however, these may have compromised maintenance of the aesthetic appearance of the graft, which was a priority of the patient and transplant team.…”

Acquired atresia and stenosis of the external acoustic meatus

“…Главным фактором, определяющим результат, является хирургическая техника. Простое удаление конгломерата атретической ткани приводит к рецидиву практически во всех случаях [18,53].…”

The outcomes of endoscopic myringoplasty: elevating a tympanomeatal flap or not

“…Often a second operation is needed to expand the external auditory canal and to reconstruct the external auditory canal. [11][12][13] The feasibility of ear surgery under endoscopy has been recognised by some surgeons, but most studies have focused on the comparison of microscopic and endoscopic surgery. There are few studies comparing the difference between the transcanal approach and tympanomeatal flap approach in endoscopic myringoplasty.…”