Surgical Treatment of Acquired Atresia of the External Auditory Ear Canal.

Introduction Acquired atresia of the external auditory canal is characterized by the formation of fibrous tissue in the medial part. The causes include chronic otitis externa, perforated chronic otitis media, postoperative or idiopathic healing problems. Acquired atresia presents with hearing loss and can be associated with otorrhea. Objective We analyzed the results of surgery after six months and two years by checking (1) pre- and postoperative hearing thresholds; (2) presence of otorrhea; and (3) whether a dry and patent ear canal is achieved. Methods We conducted this retrospective study at a tertiary referral center. In total, 27 ears underwent treatment with resection of the fibrotic plug followed by transplantation of a split-thickness skin graft covering the bare bone and tympanic membrane. When necessary, we combined this with a myringoplasty and a (meato-) canalplasty. Results Otorrhea was present in 59.3% of the patients initially and in 14.8% at six months and 11% at two years postoperative. A dry and patent ear canal was obtained in 55.6% after six months and in 89% of the patients after two years ( n = 27). The pure tone average before surgery was 39.1 dBHL (SD = 20 dBHL), at six months 31.4 dBHL (SD = 16.4 dBHL), and at 24 months postop 30.9 dBHL (SD = 17.1 dBHL). We observed a statistically significant improvement of hearing in 63% of the patients at six months ( p = 0.005) and in 65% after two years ( p = 0.022). Conclusions Treatment of acquired atresia remains a challenge. Using the appropriate surgical technique, including skin-grafting and regular postoperative check-up, rendered excellent results regarding otorrhea and a moderate improvement of hearing was achieved in 65% of the patients after two years.

Surgical Treatment of Acquired Atresia of the External Auditory Ear Canal

Abstract Introduction Acquired atresia of the external auditory canal is characterized by the formation of fibrous tissue in themedial part. The causes include chronic otitis externa, perforated chronic otitis media, postoperative or idiopathic healing problems. Acquired atresia presents with hearing loss and can be associated with otorrhea. Objective We analyzed the results of surgery after six months and two years by checking (1) pre- and postoperative hearing thresholds; (2) presence of otorrhea; and (3) whether a dry and patent ear canal is achieved. Methods We conducted this retrospective study at a tertiary referral center. In total, 27 ears underwent treatment with resection of the fibrotic plug followed by transplantation of a split-thickness skin graft covering the bare bone and tympanic membrane. When necessary, we combined this with a myringoplasty and a (meato-) canalplasty. Results Otorrhea was present in 59.3% of the patients initially and in 14.8% at six months and 11% at two years postoperative. A dry and patent ear canal was obtained in 55.6% after six months and in 89% of the patients after two years (n = 27). The pure tone average before surgery was 39.1 dBHL (SD = 20 dBHL), at six months 31.4 dBHL (SD = 16.4 dBHL), and at 24 months postop 30.9 dBHL (SD = 17.1 dBHL). We observed a statistically significant improvement of hearing in 63% of the patients at six months (p = 0.005) and in 65% after two years (p = 0.022). Conclusions Treatment of acquired atresia remains a challenge. Using the appropriate surgical technique, including skin-grafting and regular postoperative check-up, rendered excellent results regarding otorrhea and a moderate improvement of hearing was achieved in 65% of the patients after two years.

Validity and Test-Retest Reliability of the Dutch Version of the Chronic Otitis Media Questionnaire 12 (COMQ-12).

OBJECTIVE: To test the validity and test-retest reliability of the Dutch translation of the Chronic Otitis Media Questionnaire 12 (COMQ-12). MATERIALS AND METHODS: Thirty-five healthy individuals with no history of chronic otitis media (COM) received the questionnaire as well as a group of 35 patients with complaints of COM. The healthy participants had to complete the questionnaire twice (control group 1 and control group 2) to estimate the test-retest reliability, and their scores were compared with those of the patients (group 3) to test the validity. RESULTS: The overall COMQ-12 score in control group 1 ranged from 0 to 11, in control group 2 from 0 to 6, and in group 3 from 7 to 46. The mean score in control group 1 was 1.43 [standard deviation (SD) 2.30], 1.34 in control group 2 (SD 2.06), and 27.80 in group 3 (SD 10.51). A comparison of the absolute COMQ-12 scores of the two control groups and the patient group showed a significantly higher COMQ-12 score in patients with COM than in controls. The diagnostic accuracy was investigated, and a COMQ-12 cut-off score of 8 was found to have a near-perfect sensitivity and specificity in distinguishing between the presence and absence of COM. The single-measures intraclass correlation coefficient for absolute agreement (ICCAA) was 0.859 (with a 95% confidence interval from 0.738 to 0.926). This clearly exceeded the ICC threshold for acceptable reliability (ICC≥0.75) and therefore confirmed that there was reasonable test-retest reliability when applying the questionnaire to control subjects. CONCLUSION: The Dutch version of the COMQ-12 has good validity, diagnostic accuracy, and test-retest reliability.