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Postinflammatory medial meatal fibrosis: early and late surgical outcomes

Published online by Cambridge University Press:  19 November 2013

A Ghani*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Worcester Hospital, UK
M C F Smith
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Worcester Hospital, UK
*
Address for correspondence: Miss Assia Ghani, 26 Marlborough Road, Newport, Gwent NP19 0BX, Wales E-mail: ghanias@doctors.org.uk

Abstract

Objectives:

To evaluate the primary and long-term surgical outcomes of patients with postinflammatory medial meatal fibrosis.

Methods:

A retrospective study was conducted of 14 ears (in 12 patients) with postinflammatory medial meatal fibrosis managed surgically. Outcome measures were primary (i.e. less than six months) and long-term (i.e. greater than five years) closure of the air–bone gap, and the incidence of otorrhoea and restenosis.

Results:

At primary review, the mean air–bone gap ± standard deviation had decreased from 29.9 ± 11.6 dB to 12 ± 8.4 dB (p < 0.0006). Seven (50 per cent) ears had closure of the air–bone gap to within 10 dB. However, for the 9 ears receiving long-term review, the mean air–bone gap ± standard deviation increased to 19.3 ± 15.2 dB; there was no significant difference between this result and pre-operative values (p = 0.06). Of the 9 long-term review ears, 3 (33 per cent) showed closure of the air–bone gap to within 10 dB. Recurrent otorrhoea was the most common complication, occurring in 5 of the 9 long-term review ears (56 per cent); in addition, 3 (33 per cent) of these 9 ears developed restenosis.

Conclusion:

Over time, the success of surgery for postinflammatory medial meatal fibrosis diminishes. This was demonstrated in the present study by progressive post-operative hearing decline and a high prevalence of otorrhoea and restenosis.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Presented at the 9th International Conference on Cholesteatoma and Ear Surgery, 3–7 June 2012, Nagasaki, Japan

References

1Tos, M, Balle, B. Postinflammatory acquired atresia of the external auditory canal: late results of surgery. Am J Otol 1986;7:365–70Google ScholarPubMed
2Toynbee, J. The Diseases of the Ear: Their Nature, Diagnosis and Treatment. Philadelphia: Blancard and Lea, 1860Google Scholar
3Bonding, P, Tos, M. Postinflammatory acquired atresia of the external auditory canal. Acta Otolaryngol 1975;79:115–23CrossRefGoogle ScholarPubMed
4Lavy, J, Fagan, P. Chronic stenosing external otitis/postinflammatory acquired atresia: a review. Clin Otolaryngol 2000;25:435–9CrossRefGoogle ScholarPubMed
5Paparella, MM, Kurkjian, JM. Surgical treatment for chronic stenosing external otitis. (Including finding of an unusual canal tumour). Laryngoscope 1966;76:232–45CrossRefGoogle Scholar
6Macdonald, TJ, Facer, GW, Clark, JL. Surgical treatment of stenosis of the external auditory canal. Laryngoscope 1986;96:830–3CrossRefGoogle Scholar
7Cremers, WR, Smeets, JH. Acquired atresia of the external auditory canal. Surgical treatment and results. Arch Otolaryngol Head Neck Surg 1993;119:162–4CrossRefGoogle ScholarPubMed
8Keohane, JD, Ruby, RR, Janzen, VD, MacRae, DL, Parnes, LS. Medial meatal fibrosis: the University of Western Ontario experience. Am J Otol 1993;14:172–5Google ScholarPubMed
9Magliulo, G, Ronzoni, R, Cristofari, P. Medial meatal fibrosis: current approach. J Laryngol Otol 1996;110:417–20CrossRefGoogle ScholarPubMed
10Birman, CS, Fagan, PA. Medial canal stenosis: chronic stenosing external otitis. Am J Otol 1996;17:26Google ScholarPubMed
11Slattery, H, Saadat, P. Postinflammatory medial canal fibrosis. Am J Otol 1997;18:294–7Google ScholarPubMed
12Becker, BC, Tos, M. Postinflammatory atresia of the external auditory canal: treatment and results of surgery over 27 years. Laryngoscope 1998;108:903–7CrossRefGoogle ScholarPubMed
13El-Sayed, Y. Acquired medial canal fibrosis. J Laryngol Otol 1998;112:145–9CrossRefGoogle ScholarPubMed
14Lin, VY, Chee, GH, David, EA, Chen, JM. Medial canal fibrosis: surgical technique, results and a proposed grading system. Otol Neurotol 2005;26:825–9CrossRefGoogle Scholar
15Jacobson, N, Mills, R. Management of stenosis and acquired atersia of the external auditory meatus. J Laryngol Otol 2006;120:266–71CrossRefGoogle Scholar
16Soliman, T, Fatt-Hi, A, Abdel Khadir, M. A simplified technique for the management of acquired atresia of the external auditory canal. J Laryngol Otol 1980;94:549–52CrossRefGoogle Scholar
17Moore, GF, Moore, IJ, Yonkers, AJ, Nissen, AJ. Use of full thickness skin grafts in canalplasty. Laryngoscope 1984;94:1117–18CrossRefGoogle ScholarPubMed
18Hughes, RG, Courteney-Harris, RG, Wilson, PS. Longer term follow up for the treatment of chronic otitis externa by KTP/532 laser. J Laryngol Otol 2001;115:862Google ScholarPubMed