CC-BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2017; 21(04): 343-346
DOI: 10.1055/s-0037-1598604
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Surgical Treatment of Acquired Atresia of the External Auditory Ear Canal

Valerie Droessaert
Department of ENT, European Institute for ORL, Wilrijk, Antwerp, Belgium
,
Robby Vanspauwen
Department of ENT, European Institute for ORL, Wilrijk, Antwerp, Belgium
,
Erwin Offeciers
Department of ENT, European Institute for ORL, Wilrijk, Antwerp, Belgium
,
Andrzej Zarowski
Department of ENT, European Institute for ORL, Wilrijk, Antwerp, Belgium
,
Joost van Dinther
Department of ENT, European Institute for ORL, Wilrijk, Antwerp, Belgium
,
Thomas Somers
Department of ENT, European Institute for ORL, Wilrijk, Antwerp, Belgium
› Author Affiliations
Further Information

Publication History

26 May 2016

06 November 2016

Publication Date:
28 February 2017 (eFirst)

Abstract

Introduction Acquired atresia of the external auditory canal is characterized by the formation of fibrous tissue in the medial part. The causes include chronic otitis externa, perforated chronic otitis media, postoperative or idiopathic healing problems. Acquired atresia presents with hearing loss and can be associated with otorrhea.

Objective We analyzed the results of surgery after six months and two years by checking (1) pre- and postoperative hearing thresholds; (2) presence of otorrhea; and (3) whether a dry and patent ear canal is achieved.

Methods We conducted this retrospective study at a tertiary referral center. In total, 27 ears underwent treatment with resection of the fibrotic plug followed by transplantation of a split-thickness skin graft covering the bare bone and tympanic membrane. When necessary, we combined this with a myringoplasty and a (meato-) canalplasty.

Results Otorrhea was present in 59.3% of the patients initially and in 14.8% at six months and 11% at two years postoperative. A dry and patent ear canal was obtained in 55.6% after six months and in 89% of the patients after two years (n = 27). The pure tone average before surgery was 39.1 dBHL (SD = 20 dBHL), at six months 31.4 dBHL (SD = 16.4 dBHL), and at 24 months postop 30.9 dBHL (SD = 17.1 dBHL). We observed a statistically significant improvement of hearing in 63% of the patients at six months (p = 0.005) and in 65% after two years (p = 0.022).

Conclusions Treatment of acquired atresia remains a challenge. Using the appropriate surgical technique, including skin-grafting and regular postoperative check-up, rendered excellent results regarding otorrhea and a moderate improvement of hearing was achieved in 65% of the patients after two years.