title: Postinflammatory medial meatal fibrosis: early and late surgical outcomes.
abstract: OBJECTIVE
  To evaluate the primary and long-term surgical outcomes of patients with postinflammatory medial meatal fibrosis.
  
  
  METHODS
  A retrospective study was conducted of 14 ears (in 12 patients) with postinflammatory medial meatal fibrosis managed surgically. Outcome measures were primary (i.e. less than six months) and long-term (i.e. greater than five years) closure of the air-bone gap, and the incidence of otorrhoea and restenosis.
  
  
  RESULTS
  At primary review, the mean air-bone gap ± standard deviation had decreased from 29.9 ± 11.6 dB to 12 ± 8.4 dB (p < 0.0006). Seven (50 per cent) ears had closure of the air-bone gap to within 10 dB. However, for the 9 ears receiving long-term review, the mean air-bone gap ± standard deviation increased to 19.3 ± 15.2 dB; there was no significant difference between this result and pre-operative values (p = 0.06). Of the 9 long-term review ears, 3 (33 per cent) showed closure of the air-bone gap to within 10 dB. Recurrent otorrhoea was the most common complication, occurring in 5 of the 9 long-term review ears (56 per cent); in addition, 3 (33 per cent) of these 9 ears developed restenosis.
  
  
  CONCLUSIONS
  Over time, the success of surgery for postinflammatory medial meatal fibrosis diminishes. This was demonstrated in the present study by progressive post-operative hearing decline and a high prevalence of otorrhoea and restenosis.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Worcester Hospital, UK.
authors.forename: A
authors.initials: A
authors.lastname: Ghani
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Worcester Hospital, UK.
authors.forename: M C F
authors.initials: MC
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004424:Ear Canal / Q000473:pathology* / Q000601:surgery; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010032:Otitis Externa / Q000150:complications*; D010035:Otitis Media, Suppurative / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology