A Rare Case of Post Inflammatory Lateral Stenosis of External Auditory Canal and It's Management with Review of Literatu
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ORIGINAL ARTICLE
A Rare Case of Post Inflammatory Lateral Stenosis of External Auditory Canal and It’s Management with Review of Literature Saranya Sasikumar1 • S. G. Maneesh1 • Sobhana Chandran1 • K. S. Raghavendra1 • Suhel Hasan1 • I. P Umerali1 • Monica Mrudubhashini Michael1 • K. G. Yadu Krishnan1 • Chinchu Raveendran1 • S. Malavika1
Received: 4 September 2020 / Accepted: 5 October 2020 Ó Association of Otolaryngologists of India 2020
Abstract Acquired external auditory canal stenosis is a challenging condition to treat and can affect any age group. Post inflammatory lateral canal atresia is uncommon. This article focuses on a 2 year old child who presented with hearing loss with history of otitis externa. The lateral part of Auditory Canal was completely stenosed. He underwent debrider assisted endoscopic ear surgery and stenting, and a patent External Auditory Canal with normal hearing was achieved. Keywords Post inflammatory external auditory canal stenosis Acquired external auditory canal stenosis Paediatric external auditory canal stenosis Lateral stenosis of external auditory canal
Introduction Acquired atresia of the external auditory canal [EAC] has been classified by Tos et al. into 4 categories: Post-traumatic, post-operative, neoplastic and post-inflammatory [1]. The post-inflammatory group is a rare disorder with an estimated annual incidence of 0.6 cases per 100,000 [2]. Acquired atresia of EAC is a rare condition in which usually the medial part of the ear canal is blocked by a fibrotic plug. Although the pathophysiology is still not fully understood, it is generally felt that chronic inflammation leads to loss of the epithelial layer of the tympanic & Saranya Sasikumar [email protected] 1
Department of ENT, Narayana Hrudayalaya, Bangalore, India
membrane [TM] and subsequent formation of immature granulations on the fibrous layer. These granulations undergo fibrous degeneration and in the presence of persistent inflammation, further deposition of granulations and the ensuing fibrosis leads to the formation of a fibrous plug that progressively fills the EAC. Eventually, the fibrotic plug reaches the bony-cartilaginous junction and epithelisation may occur. Usually, the lateral part of the canal remains patent and takes the form of a blind ending pouch. This anomaly often results in a severe conductive hearing loss [3]. Other causes of acquired EAC stenosis include fibrosis after surgery, radiotherapy, trauma, dermatological conditions, neoplastic, etc. [4]. There are only a few publications about post inflammatory EAC stenosis, its aetiology, progress and adequate therapy [5]. Here we present an interesting case report of a toddler who developed atresia of the lateral cartilaginous canal wall of the right ear secondary to inflammation.
Case Report A 2-year-old male child, who had a history of congenital biliary atresia, status post liver transplantation at 8 months of age, presented to us with progressive right sided hearing loss since past 6 months. The parents complained of r
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