Surgical treatment of monostotic fibrous dysplasia of the temporal bone: a retrospective analysis.

OBJECTIVE

The aim of this study was to analyze the therapeutic effect of external auditory canal stenosis caused by monostotic fibrous dysplasia of the temporal bone by operation.

METHODS

Seven patients who were finally diagnosed as having monostotic fibrous dysplasia of the temporal bone by temporal bone high-resolution computed tomography (CT) and pathological diagnosis after operation underwent surgical reconstruction of the external auditory canal. The follow-up lasted 2 to 6 years, and it included pure-tone audiometry otoendoscopy, and high-resolution CT of the temporal bone. The hearing recovery and formed external auditory meatus results were retrospectively analyzed. The data were obtained from the Department of Otolaryngology in Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, from April 2003 to September 2008.

RESULTS

We found 4 ears with combined external auditory canal cholesteatoma intraoperative. The mean pure-tone audiometries (0.5, 1, 2 kHz) and the air-bone gaps for all patients improved after 6 months postoperation. The result was statistically significant. The average air-bone gap was improved, and the external auditory canal restenosis appeared in 1 patient after 4 years. Reconstruction of the external auditory canal was performed in this patient, and no restenosis was found in subsequent 2-year follow-up. All cases were reviewed with CT and otoendoscopy to observe the results and lesion extent, and we found that the lesion was basically stable without significant progress to the periphery major structure.

CONCLUSION

The monostotic fibrous dysplasia of the temporal bone and its causative external auditory meatus stenosis must be treated as early as possible to recover its patency of external auditory canal to prevent complicated cholesteatoma. Satisfaction results can be obtained from surgical reconstruction of the external auditory canal. We can excise the pathological change of the external auditory canal simply to restore auditory function and eliminate clinical symptoms such as earache, ear muffled sense, and so on. Because the development of lesions was slow during the follow-up, the complete resection of all lesions was not necessary, the external auditory canal restenosis may be operated again, and the prognosis was optimistic.