Schwarz David, Luers Jan Christoffer, Huttenbrink Karl Bernd, Stuermer Konrad Johannes
a Department of Otorhinolaryngology , Medical Faculty, Head and Neck Surgery, University of Cologne , Cologne , Germany.
Acta Otolaryngol. 2018 Sep;138(9):790-794. doi: 10.1080/00016489.2018.1476779. Epub 2018 May 31.
The surgical treatment of acquired post-inflammatory atresia of the external auditory canal (EAC) is challenging. Based on the long-term surgical experience, a modified split skin graft technique has been established at our clinic.
AIMS/OBJECTIVES: The aim was to evaluate the clinical and audiological data and patient satisfaction after performing meatoplasty.
In total, 16 patients were included who underwent intraoperative enlargement of the bony EAC, resection of the fibrotic scar tissue, reconstruction with split skin grafts and splinting of the anterior tympanomeatal angle in the period of 2004-2016. Patients presented at a long-term follow-up appointment for reevaluation.
The mean follow-up time was 52 months after surgery. The pure-tone average (52 dB vs. 31 dB) and the air-bone gap (27 dB vs. 11 dB) decreased significantly compared to the preoperative status. The grade of stenosis also showed a significant improvement during the follow-up visit. Complete re-atresia was observed only in two patients (10.5%).
The applied surgical technique is a safe and successful treatment option for acquired atresia of the EAC.
The study provides important data for the surgical treatment of acquired atresia of the EAC and corroborates the significance of intensive aftercare.
后天性炎症后外耳道闭锁（EAC）的手术治疗具有挑战性。基于长期的手术经验，我们诊所建立了一种改良的植皮技术。
目的是评估行外耳道成形术后的临床、听力学数据及患者满意度。
2004年至2016年期间，共纳入16例患者，这些患者均接受了术中扩大骨性外耳道、切除纤维化瘢痕组织、用植皮进行重建以及固定鼓室前角的治疗。患者前来进行长期随访复诊以重新评估。
术后平均随访时间为52个月。与术前相比，纯音平均听阈（52dB对31dB）和气骨导差（27dB对11dB）显著降低。随访期间狭窄程度也有显著改善。仅2例患者（10.5%）出现完全再闭锁。
所应用的手术技术是后天性外耳道闭锁的一种安全且成功的治疗选择。
该研究为后天性外耳道闭锁的手术治疗提供了重要数据，并证实了强化术后护理的重要性。
