Complete medial canal fibrosis.A 31-year-old woman was referred to our clinic with complaints of hearing loss and long-standing drainage from the right ear. She had no history of ear surgery. Our otologic examination revealed that the right ear canal ear canal n. The narrow, tubelike passage through which sound enters the ear. Also called external auditory canal. was short and terminated with a skin-covered barrier (figure 1). Audiometry and tympanometry of the right ear revealed a flat 30-dB conductive hearing loss Conductive hearing loss A type of medically treatable hearing loss in which the inner ear is usually normal, but there are specific problems in the middle or outer ears that prevent sound from getting to the inner ear in a normal way. . A diagnosis of complete acquired medial canal fibrosis was made and subsequently confirmed by temporal bone computed tomography (CT) (figure 2). [FIGURES 1-2 OMITTED] Acquired medial canal fibrosis is a rare atresia atresia /atre·sia/ (ah-tre´zhah) congenital absence or closure of a normal body opening or tubular structure.atret´ic anal atresia , atresia a´ni imperforate anus. that is characterized by the formation of thick, solid fibrous tissue in the medial part of the external ear canal. It may be associated with chronic otitis media Chronic otitis media Inflammation of the middle ear with signs of infection lasting three months or longer. Mentioned in: Myringotomy and Ear Tubes chronic otitis media or chronic otitis externa chronic otitis externa Otitis externa ENT A condition of young adults, characterized by inflammation, irritation or infection of the external auditory canal, caused by mechanical trauma or chemical irritation. Cf Otitis media. , and it may occur following a tympanoplasty tympanoplasty /tym·pa·no·plas·ty/ (tim´pah-no-plas?te) surgical reconstruction of the tympanic membrane and establishment of ossicular continuity from the tympanic membrane to the oval window. . Other causes include nonsurgical trauma such as thermal or chemical burns and gunshot wounds. It has been speculated that the initial insult stimulates the formation of granulation tissue on the epithelium of the external ear canal and on the tympanic membrane. With recurrent infection, granulation tissue matures with extensive fibrosis, and the external ear canal may become partially or completely obliterated by this inflammatory process. (1) The only effective treatment is surgery. The main goals of surgery are to reestablish a patent epithelium-lined ear canal for good sound conduction and to prevent canal cholesteatoma. The surgical procedure involves removal of the fibrotic tissue, canaloplasty, meatoplasty, and skin grafting. (1-4) In the case described herein, a canaloplasty with skin grafting and tympanoplasty resulted in closure of the airbone gap and resolution of symptoms. At the 6-month follow-up, the patient remained symptom-free. References (1.) el-Sayed Y. Acquired medial canal fibrosis. J Laryngol Otol 1998: 112:145-9. (2.) Slattery WH III, Saadat R Postinflammatory medial canal fibrosis. Am J Otol 1997:18:294-7. (3.) Birman CS, Fagan PA. Medial canal stenosis--Chronic stenosing external otitis otitis Inflammation of the ear. Otitis externa is dermatitis, usually bacterial, of the auditory canal and sometimes the external ear. It can cause a foul discharge, pain, fever, and sporadic deafness. . Am J Otol 1996;17:2-6. (4.) Eshraghi AA, Ulubil SA. Partial medial canal fibrosis. Ear Nose Throat J [In press]. From the University of Miami This article is about the university in Coral Gables, Florida. For the university in Oxford, Ohio, see Miami University. The University of Miami (also known as Miami of Florida,[2] UM,[3] or just The U Ear Institute, Department of Otolaryngology, University of Miami Miller School of Medicine. S. Arif Ulubil, MD; Adrien A. Eshraghi, MD |
|
||||||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion