Varghese Sunil Sam, Kumar Navneet, Philipose Rebecca
Department of E.N.T, Chrisitan medical college, Ludhiana, Punjab India.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3889-3894. doi: 10.1007/s12070-023-03941-9. Epub 2023 Jun 14.
Acquired external auditory canal (EAC) stenosis is an uncommon condition with an incidence of 0.6 in 100,000 population. Road traffic accidents and otology surgeries are the frequently reported causes for it to occur. The high rate of restenosis makes this condition difficult to manage. A 50 year old lady presented with history of accidental instillation of acid in her left ear at 6 months of age by the care giver. The patient developed stenosis of left EAC with hearing loss. Examination revealed pin point stenosis of left EAC. Puretone audiogram revealed a moderately severe conductive hearing loss. Computed tomogram showed soft tissue lesion obliterating the entire EAC and extending into the middle ear and antrum. Intra operatively only the cartilaginous EAC was stenosed. Surgical excision of the fibrotic scar with a tympanomastoidectomy and wide meatoplasty was done. Regular post operative aural toileting, packing with merocele strips and application of topical antibiotic -steroid preparations was done. 6 months post-surgery a patent EAC and healed tympanic membrane was achieved. In this report, we present a rare case of lateral EAC stenosis secondary to corrosive acid injury, highlighting the surgical steps, post operative care and surgical outcomes. A limited review of literature is also presented.
获得性外耳道狭窄是一种罕见疾病,在每10万人中的发病率为0.6。道路交通事故和耳科手术是其常见的发病原因。再狭窄率高使得这种疾病难以治疗。一名50岁女性,6个月大时被护理人员意外将酸滴入左耳。患者出现左耳外耳道狭窄并伴有听力损失。检查发现左耳外耳道针尖样狭窄。纯音听力图显示为中度重度传导性听力损失。计算机断层扫描显示软组织病变阻塞整个外耳道并延伸至中耳和鼓窦。术中仅软骨部外耳道狭窄。采用鼓室乳突切除术和广泛的外耳道成形术切除纤维化瘢痕。术后定期进行耳部清洁,用美罗培南条带填塞,并应用局部抗生素 - 类固醇制剂。术后6个月,外耳道通畅,鼓膜愈合。在本报告中,我们展示了一例罕见的因腐蚀性酸损伤继发外侧外耳道狭窄的病例,突出了手术步骤、术后护理和手术结果。还对相关文献进行了有限的综述。