Potter C P S, Bottrill I D
ENT Department, John Radcliffe Hospital, Oxford, UK.
J Laryngol Otol. 2012 Oct;126(10):1016-21. doi: 10.1017/S0022215112001703. Epub 2012 Aug 15.
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.
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.
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).
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.
慢性闭塞性外耳道炎是传导性听力损失的罕见病因，其特征为慢性炎症继发深部耳道狭窄。已有多种外耳道成形术被描述，但成功率各异。
本研究纳入了在8年期间由资深作者为治疗难治性闭塞性外耳道炎而进行外耳道成形术的14例患者。所有患者均接受了裸露耳道的植皮术及精心的术后耳部护理。观察指标包括格拉斯哥效益量表和纯音听力学检查。
术后3个月，患侧耳的四频率平均听阈平均改善了13.9dB（95%置信区间为-9.9至37.8dB；t<0.001）。格拉斯哥效益量表的平均得分是20（95%置信区间为-2.3至42.1）。
对于终末期闭塞性外耳道炎患者，手术治疗可显著改善听力和生活质量。训练有素且称职的耳部护理从业者是该手术成功的前提条件，并且必须有相当数量的患者愿意接受长期随访护理。
