Role of Pre Auricular Flap in Reconstruction of Acquired Meatal Stenosis Via Endaural Approach
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ORIGINAL ARTICLE
Role of Pre Auricular Flap in Reconstruction of Acquired Meatal Stenosis Via Endaural Approach Chetan Bansal1
•
Arvind Varma2 • V. P. Singh3
Received: 18 August 2020 / Accepted: 27 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract Acquired meatal stenosis is a difficult entity to treat with a significant recurrence rate. It is normally approached posteriorly via post aural approach and reconstructed using split thickness skin graft. We are presenting a novel method of surgery for acquired meatal stenosis using a pre auricular flap via endaural approach only. The aim was to evaluate the success rate of using a pre auricular flap in acquired atresia of the external auditory canal using the endaural approach. Twenty patients with acquired atresia of the external auditory canal that was surgically treated were retrospectively studied from July 2012 to July 2018. All cases were done using endaural approach only. During the surgery, the atretic tissue was removed, wide canaloplasty done and the stenotic segment widened. Reconstruction of the external auditory canal was done using a pedicled anteriorly based pre auricular flap rotating it into the external auditory canal to cover the bare bone. Of the 20 patrients there were good results in 18 patients with restenosis occurring only in 2 patients. However, a skin tag developed in 2 other patients which was excsiced as OPD procedure and patient was asymptomatic on further follow ups. In all the 20 cases preauricular flap was used for reconstruction along with use of Split thickness skin graft in 10 cases. All 20 cases were operated via endaural route only. Use of a Preauricular flap in surgical treatment of acquired aural stenosis gives good results with a wide dry cavity as the flap is pedicled with its & Chetan Bansal [email protected] 1
Department of ENT, ONGC Hospital, Dehradun, Uttarakhand, India
2
Department of ENT, SMIH, Dehradun, India
3
Department of ENT, Max Dehradun, Dehradun, India
vascular supply and it can be tailor made according to each case and requirement. Keywords Acquired aural atresia Pre auricular flap Conductive hearing loss Meatoplasty Canalplasty
Introduction Acquired meatal stenosis is a disorder of the external auditory canal characterized by formation of mature fibrous tissue in the external auditory meatus [1, 2] resulting in the narrowing of the external auditory meatus with its long term effects such ranging from deafness and impacted wax, keratosis obturans, external canal cholesteatoma and chronic otitis externa. Its incidence has been estimated at 0.6 cases per 100,000 by Becker and Tos [1, 2] in 1998. Acquired meatal stenosis commonly occurs after trauma, post ear surgery or due to inflammations [1, 2]. This poses a significant challenge for the surgeon for its notorious recurrence. Most studies stress and aim the role of SSG in reconstruction of acquired meatal stenosis [1, 2] using post aural approach, however we have found that using an endural approach along with a previously
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