title: Postinflammatory medial canal fibrosis: An institutional review and meta-analysis of short- and long-term outcomes.
abstract: Few studies report outcomes of surgical management of postinflammatory medial canal fibrosis (PIMCF). The objectives were to compare short- and long-term outcomes after surgical repair of PIMCF at our institution and systematically aggregate published data for meta-analysis.
  
  
  
  Medical records for the case series; PubMed, Scopus, and OVID/Medline for the systematic review/meta-analysis.
  
  
  
  Patients undergoing surgical treatment of PIMCF were identified. Short-term (<2 years) and long-term (>2 years) postoperative outcomes were evaluated for the case series and aggregated for the meta-analysis.
  
  
  
  At our institution, 16 patients (21 ears) were identified. Compared to the preoperative air-bone gap (ABG) (27.7 ± 7.5 dB), mean postoperative short-term ABG (8.2 ± 7.5 dB) and long-term ABG (15.3 ± 11.3 dB) were significantly improved (P < 0.001 for both). Although short-term restenosis rate was low (0%) among long-term follow-up patients, 64% (9 of 14) experienced some degree of recurrent canal narrowing, including one case of complete restenosis (7%). Similarly, meta-analysis pooled preoperative ABG (29.3 ± 9.7 dB, 95% confidence interval [CI] 27.0-31.6) improved significantly during short-term (11.4 ± 8.0 dB, 95% CI 8.3-4.5, P < 0.0001) and long-term (14.3 ± 9.6 dB, 95% CI 11.6-16.9, P = 0.0004) follow-ups, with partial deterioration in hearing over time. Long-term complete restenosis rate (13.8%) was worse than short-term (8.0%), with no significant difference over time (P = 0.85).
  
  
  
  Postinflammatory medial canal fibrosis is a rare condition that can successfully be treated with surgery to restore patency of the external auditory canal. Patients who experience improved hearing early on, however, are at significant risk of restenosis and recurrence of their conductive hearing loss with time.
  
  
  
  N/A. Laryngoscope, 2016 127:488-495, 2017.
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors: Robert G
authors: RG
authors: Keller
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors: Adrian A
authors: AA
authors: Ong
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors: Shaun A
authors: SA
authors: Nguyen
authors: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
authors: Brendan P
authors: BP
authors: O'Connell
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors: Paul R
authors: PR
authors: Lambert
mesh_terms: D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D001844:Bone Conduction; D002908:Chronic Disease; D004424:Ear Canal / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D010032:Otitis Externa / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D010035:Otitis Media, Suppurative / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D012008:Recurrence; D016038:Skin Transplantation; D013069:Speech Reception Threshold Test; D055815:Young Adult
keywords: Medial canal fibrosis; air-bone gap; canaloplasty; external auditory canal; stenosis