Acquired atresia of the external auditory canal: long-term clinical and audiometric results after surgery

OBJECTIVE: Acquired atresia of the external auditory canal is a rare condition in which the medial part of the external auditory canal is obliterated by a soft fibrous plug, mostly as a result of chronic inflammation of the outer ear canal. In this study, the clinical and audiometric long-term postsurgical results were assessed. PATIENTS: Records of patients with acquired atresia, surgically treated in a tertiary referral center during the period 2000-2009, were retrospectively reviewed. Preoperative and postoperative clinical and audiometric data were collected. INTERVENTION: All patients underwent the same surgical technique, consisting of a maximal bony canaloplasty with coverage of the bony ear canal using full-thickness skin graft and a meatoplasty. Eligible patients were reinvited for objective and subjective evaluation. MAIN OUTCOME MEASURES: The primary outcome was the long-term postoperative status, based on clinical (patency and condition of the external auditory canal) and audiometric findings (mean air-bone gap). RESULTS: The analysis comprised 17 operated ears (14 different patients). Mean follow-up time was 5.14 years. True recurrence occurred in 3 ears (17.6%), whereas another 4 ears had episodic otorrhea (23.5%). At early (4y), the air-bone gap in the operated ears was significantly smaller. CONCLUSION: Surgical treatment for acquired atresia leads to beneficial results. Patients should be informed of the possibility of recurrence of disease. Nevertheless, they seem to be satisfied with the surgical intervention. Preoperative dermatologic referral is required, given the high prevalence of an underlying dermatologic disease