Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T03:16:23.012Z Has data issue: false hasContentIssue false
  • English
  • Français

Outcomes of canalplasty for chronic obliterative otitis externa

Published online by Cambridge University Press:  15 August 2012

C P S Potter  and
I D Bottrill
C P S Potter*
Affiliation:
ENT Department, John Radcliffe Hospital, Oxford, UK
I D Bottrill
Affiliation:
ENT Department, John Radcliffe Hospital, Oxford, UK
*
Address for correspondence: Mr C P S Potter, ENT Department, Torbay Hospital, Torquay TQ2 7AA, UK Fax: +44 (0)1803 655011 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Chronic obliterative otitis externa is a rare cause of conductive hearing loss, characterised by stenosis of the deep ear canal secondary to chronic inflammation. A multitude of canalplasty techniques have been described, with variable success.

Method:

Fourteen patients undergoing canalplasty performed by the senior author for refractory obliterative otitis externa, over an 8-year period, were included in the study. All underwent split-skin grafting of the denuded canal and meticulous post-operative aural care. Outcome measures included the Glasgow Benefit Inventory and pure tone audiology.

Results:

At 3 months post-operatively, the four-tone average threshold had improved by a mean of 13.9 dB (95 per cent confidence interval –9.9 to 37.8 dB; t < 0.001) in the operated ear. The mean Glasgow Benefit Inventory score was 20 (95 per cent confidence interval −2.3 to 42.1).

Conclusion:

Significant improvements in both hearing and quality of life are achievable in patients with end-stage obliterative otitis externa treated surgically. Highly trained and competent aural care practitioners are a prerequisite for the success of the procedure, and a substantial number of patients must be prepared to submit to long-term follow-up care.

Keywords

Otitis ExternaEar CanalGraftingSkinFibrosisOtologic Surgical Procedure
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 10 , October 2012 , pp. 1016 - 1021
Copyright
Copyright © JLO (1984) Limited 2012

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.)

References

1Becker, BC, Tos, M. Postinflammatory acquired atresia of the external auditory canal: treatment and results of surgery over 27 years. Laryngoscope 1998;108:903–7CrossRefGoogle ScholarPubMed
2Roland, PS. Chronic external otitis. Ear Nose Throat J 2001;80:12–16Google ScholarPubMed
3Selesnick, S, Nguyen, TP, Eisenman, DJ. Surgical treatment of acquired external auditory canal atresia. Am J Otol 1998;19:123–30Google ScholarPubMed
4Robinson, K, Gatehouse, S, Browning, GG. Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 1996;105:415–22CrossRefGoogle ScholarPubMed
5Herdman, RC, Wright, JL. Surgical treatment of obliterative otitis externa. Clin Otolaryngol Allied Sci 1990;15:11–14CrossRefGoogle ScholarPubMed
6Jacobsen, N, Mills, R. Management of stenosis and acquired atresia of the external auditory meatus. J Laryngol Otol 2006;120:266–71CrossRefGoogle ScholarPubMed
7Katzke, D, Pohl, DV. Postinflammatory medial meatal fibrosis. A neglected entity? Arch Otolaryngol 1982;108:779–80CrossRefGoogle ScholarPubMed
8el-Sayed, Y. Acquired medial canal fibrosis. J Laryngol Otol 1998;112:145–9CrossRefGoogle ScholarPubMed
9Bonding, P, Tos, M. Postinflammatory acquired atresia of the external auditory canal. Acta Otolaryngol 1975;79:115–23CrossRefGoogle ScholarPubMed
10McKennan, KX, Chole, RA. Traumatic external auditory canal atresia. Am J Otol 1992;13:80–1Google ScholarPubMed
11McDonald, TJ, Facer, GW, Clark, JL. Surgical treatment of stenosis of the external auditory canal. Laryngoscope 1986;96:830–3CrossRefGoogle ScholarPubMed
12McCary, WS, Kryzer, TC, Lambert, PR. Application of split-thickness skin grafts for acquired diseases of the external auditory canal. Am J Otol 1995;16:801–5Google ScholarPubMed
13Carls, JL, Mendenhall, WM, Morris, CG, Antonelli, PJ. External auditory canal stenosis after radiation therapy. Laryngoscope 2002;112:1975–8CrossRefGoogle ScholarPubMed
14Work, WP. Lesions of the external auditory canal. Ann Otol Rhinol Laryngol 1950;59:1062–87CrossRefGoogle ScholarPubMed
15Paparella, MM, Kurkjian, JM. Surgical treatment for chronic stenosing external otitis. (Including finding of unusual canal tumor). Laryngoscope 1966;76:232–45CrossRefGoogle ScholarPubMed
16Tos, M, Bonding, P. Treatment of postinflammatory acquired atresia of the external auditory canal. ORL J Otorhinolaryngol Relat Spec 1979;41:85–90CrossRefGoogle ScholarPubMed
17Cremers, CW. Surgery for acquired atresia of the external ear canal. Clin Otolaryngol Allied Sci 2002;27:75–6CrossRefGoogle ScholarPubMed
18Birman, CS, Fagan, PA. Medial canal stenosis – chronic stenosing external otitis. Am J Otol 1996;17:2–6Google ScholarPubMed
19Parisier, SC, Bent, JP 3rd. Canalplasty. Otolaryngol Clin North Am 1999;32:457–69CrossRefGoogle ScholarPubMed
20Soliman, T, Fatt-Hi, A, Abdel Kadir, M. A simplified technique for the management of acquired stenosis of the external auditory canal. J Laryngol Otol 1980;94:549–52CrossRefGoogle ScholarPubMed
21Dhooge, IJ, Vermeersch, HF. The use of two pedicled skin flaps in the surgical treatment of acquired atresia of the outer ear canal. Clin Otolaryngol Allied Sci 1999;24:58–60CrossRefGoogle ScholarPubMed
22Adkins, WY, Osguthorpe, JD. Management of canal stenosis with a transposition flap. Laryngoscope 1981;91:1267–9CrossRefGoogle ScholarPubMed
23Wolfensberger, M, Hilger, PA, Hilger, JA. Conchal bowl and postauricular flaps for reconstruction of the external auditory canal. Otolaryngol Head Neck Surg 1983;91:404–6CrossRefGoogle ScholarPubMed
24Chang, SO, Min, YG, Kim, CS, Koh, TY. Surgical management of congenital aural atresia. Laryngoscope 1994;104:606–11CrossRefGoogle ScholarPubMed
25Bell, DR. External auditory canal stenosis and atresia: dual flap surgery. J Otolaryngol 1988;17:19–21Google ScholarPubMed
26Martin-Hirsch, DP, Smelt, GJ. Conchal flap meatoplasty. J Laryngol Otol 1993;107:1029–31CrossRefGoogle ScholarPubMed
27Banerjee, AR, Moir, AA, Jervis, P, Narula, AA. A canalplasty technique for the surgical treatment of chronic otitis externa. Clin Otolaryngol Allied Sci 1995;20:150–2CrossRefGoogle ScholarPubMed
28Lavy, J, Fagan, P. Canalplasty: review of 100 cases. J Laryngol Otol 2001;115:270–3CrossRefGoogle ScholarPubMed
29Sharp, HR, Oakley, RJ, Padgham, ND. The Canterbury technique for canalplasty via an endaural approach in the surgical management of chronic refractory otitis externa. J Laryngol Otol 2003;117:195–7CrossRefGoogle ScholarPubMed
30Leek, JH. Plastic surgery of the external auditory canal. Treatment of stenosis resulting from inflammation. Arch Otolaryngol 1967;85:367–70CrossRefGoogle ScholarPubMed
31Proud, GO. Surgery for chronic, refractory otitis externa. Arch Otolaryngol 1966;83:436–8CrossRefGoogle ScholarPubMed
32Spector, GJ, Sobol, S, Thawley, SE. Split thickness skin grafting in canaloplasty for acquired ear atresia. Laryngoscope 1979;89:674–6CrossRefGoogle ScholarPubMed
33Moore, GF, Moore, IJ, Yonkers, AJ, Nissen, AJ. Use of full thickness skin grafts in canalplasty. Laryngoscope 1984;94:1117–18CrossRefGoogle ScholarPubMed
34Cremers, WR, Smeets, JH. Acquired atresia of the external auditory canal. Surgical treatment and results. Arch Otolaryngol Head Neck Surg 1993;119:162–4CrossRefGoogle ScholarPubMed
35Tos, M, Balle, V. Postinflammatory acquired atresia of the external auditory canal: late results of surgery. Am J Otol 1986;7:365–70Google ScholarPubMed
36Slattery, WH 3rd, Saadat, P. Postinflammatory medial canal fibrosis. Am J Otol 1997;18:294–7Google ScholarPubMed