The surgical treatment of acquired post-inflammatory atresia of the external auditory canal (EAC), namely meatoplasty, is challenging with variable long-term outcome. This study looked at the clinical, audiological data, long-term outcome and patient satisfaction after performing meatoplasty. Sixteen patients were included who underwent intraoperative enlargement of the bony EAC, scar tissue removal, reconstruction with split skin grafts and splinting of the anterior tympanomeatal angle. Follow-up time was 52 months after surgery. The pure-tone average (52dB vs 31dB) and the air-bone gap (27dB vs.11dB) 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%).
Authors point out that key elements for their high success rate include providing regular, almost weekly-to-two-weekly, intensive postoperative care and leaving silastic sheets at the anterior tympanomeatal angle for three months.
Most otologists will probably use a similar technique but perhaps seeing patients every two weeks in busy NHS clinics is a challenge however it may be worth considering if the success rate in this surgery improves to almost 90%!