Plastic Surgery of the External Auditory Canal: Treatment of Stenosis Resulting From Inflammation

EXTERNAL otitis is usually considered a medical problem. In an occasional case, however, the disease process is severe and progressive, with irreversible damage to the epithelial elements of the canal and lateral drum surface. Infection causes breakdown of the epithelium; granulation tissue forms and is replaced by thick fibrous tissue. If the ulcer should heal, it is covered by atrophic epithelium. Breakdown of this surface with weeping produces crusts which can form a cast of the canal. Reinfection occurs beneath the crust and the inflammatory process finally produces stenosis. The frequent and costly topical care required fails to resolve the basic disease process. Surgical intervention is proposed and the operative technique to be described is the purpose of this paper. Clinical findings in this series of cases with inflammatory stenosis showed three pathologic forms. In one, stenosis involved a ring of fibrous tissue in the osseous canal (Fig 1,