External ear canal stenosis treated with artificial skin (Pore Skin) : retrospective case series

Abstract

Background

Canaloplasty is the procedure for treating the ear canal stenosis from scar. However it is effective, the stenosis frequently recurs. Artificial skin has the property of reduction of recurrence of the scar. The authors used the Pore Skin, the artificial skin made by the investigators of Chulalongkorn University, in attempt to reducing the restenosis after canaloplasty.

Objective

Review the data of the patients who underwent the canaloplasty for ear canal stenosis. The procedures included the use of CO2 laser and Pore Skin. Its effectiveness and safe were evaluated.

Place

Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital (KCMH), Thai Red Cross Society.

Design of Study

A retrospective review of the patients who undergone canaloplasties by the senior authors between January 1, 2009 and June 30, 2010 in KCMH.

Method

Seven cases of ear canal stenosis (8 ears) who undergone canalo-plasties with CO2 laser and Pore Skin were described and evaluated.

Result

All the patients were female with average age of 41.7 years. There were 5 right ears and 3 left ears.

All the patients had the history of hearing loss for 6 years in average. Three cases also had earache and/or ear discharge.

The main causes of ear canal stenosis were tympanoplasties in 5 ears (62.5%), 1 myringotomy and otitis externa in 2 ears.

Surgical outcome revealed a wider ear canal in all ears, but frequently found the blunting anterior sulcus. One case, the stenosis recurred making a bullet shape ear canal. Audiological evaluation revealed a reduction of the air-bone gap in 6 ears (75%) and increased air-bone gap in 2 ears (25%). Moreover, we found the good hearing ear-air-bone gap of less than 15 dBin 5 ears (62.5%).

The complications included tympanic membrane perforation in 2 ears (25%) and infection of the skin graft resulting in skin loss in 4 cases (50%). In these cases, re-grafting of the skin was needed.

Conclusion

The canaloplasty with CO₂ laser and Pore Skin to correct ear canal stenosis yielded 75% success in term of ear canal width and serviceable hearing ears. This is preliminary report of this new procedure which requires further studies.