Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-28T03:52:31.522Z Has data issue: false hasContentIssue false
  • English
  • Français

Postinflammatory medial meatal fibrosis: early and late surgical outcomes

Published online by Cambridge University Press:  19 November 2013

A Ghani  and
M C F Smith
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
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Ear CanalHearing Loss, ConductiveEar DiseasesOtitis ExternaFibrosisTreatment Outcome
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 12 , December 2013 , pp. 1160 - 1168
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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;17:2–6Google 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