Article
Surgical treatment of acquired atresia of the external auditory canal
Outline
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Acquired postinflammatory atresia of the external audiotory canal is a rare complication of chronic or recurrent external otitis and/or of granulating myringitis. Squamous cell epithelium is destroyed, a granulation begins leading to a fibrotic obliteration of the auditory canal.
During the past two years 7 patients (9 ears) were treated surgically by the author. Following a retroauricular incision the external auditory meatus was opened at the level of the mastoid plane. The skin of the auditory canal was then circumcised just laterally to the fibrotic obliteration. The atresic block was divided from the bony canal wall and the eardrum’s lamina propria and removed. Next, the bony meatus was widened with a diamond burr and the canal wall and the lamina propria was covered with small split-skin grafts. Meatal tamponade and silastic sheets placed over the grafts were removed 3 weeks later.
The first operation was successful in 5 cases resulting in a well epithelized eardrum and auditory canal. Hearing returned to normal. In 2 cases the skin grafts were too thick, thus in both cases postoperative CO2 laser treatment was successfully performed three times in order to thin and epilate the skin. In another 2 cases a reoperation followed by several sessions of laser treatment was necessary. Anatomic recovery was successful in these cases, as well, with improvement in hearing.
Conclusion: Surgery of postinflammatory external auditory canal atresia combined with postoperative CO2 treatment may be successful in every case.
