Long-term stent use can prevent postoperative canal stenosis in patients with congenital aural atresia.
OBJECTIVE
Postoperative external auditory canal (EAC) stenosis is the most common complication after congenital aural atresia (CAA) surgery. The authors applied an ear mold or hearing aid as an EAC stent following surgery and analyzed the impact on postoperative EAC stenosis.


METHODS
Historical cohort study.


METHODS
A tertiary hospital.


METHODS
Ninety-six patients who underwent canaloplasty between 1996 and 2010 were included in this study. To discover factors contributing to postoperative EAC stenosis, clinical parameters, including age, sex, Marx grading, Schuknecht classification, Jahrsdoerfer score, surgical approach, triamcinolone injection, and use of stenting with an ear mold or hearing aid, were reviewed and analyzed. Each stent was used for at least 6 months postoperatively. Pure-tone audiometry was performed preoperatively and 3, 6, and 12 months after canaloplasty.


RESULTS
Postoperative EAC stenosis was the most common postoperative complication, occurring in 8 (8.2%) cases with a mean time interval of 4.1 months. For patients who did not use an ear mold or a hearing aid during the postoperative follow-up period, the relative risk for the development of postoperative EAC stenosis was 5.125 (95% confidence interval, 1.428-18.400; P = .023). Other factors did not show an association with postoperative stenosis. Preoperative air-bone gap (ABG) was 49.00 dB, and closure of the ABG within 30 dB was obtained in 56.9%, 58.1%, and 48.7% of patients at the 3-, 6-, and 12-month follow-up, respectively.


CONCLUSIONS
Stenting with an ear mold or hearing aid might be a useful method for preventing postoperative EAC stenosis in CAA patients.
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Il Joon
IJ
Moon
Yang-Sun
YS
Cho
Juyeon
J
Park
Won-Ho
WH
Chung
Sung Hwa
SH
Hong
Sun O
SO
Chang
D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000517:prevention & control; D054644:Ear Auricle / Q000002:abnormalities* / Q000601:surgery; D004424:Ear Canal; D005260:Female; D006310:Hearing Aids; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D019736:Prostheses and Implants; D012189:Retrospective Studies; D015607:Stents; D013524:Surgical Flaps