Cicatricial processes in the external auditory canal and methods of their correction

Cover Page

Cite item

Full Text

Abstract

In the literature review, the scar processes of the external auditory canal (EAC) are examined from the point of view of their formation, their surgical correction and conservative treatment. Various surgical techniques are presented that form an idea of the elimination of atresia of the EAC. Since resection of atretic tissue is associated with the risk of restenosis, various techniques for the plasticization of the EAC are presented, which reduce the possibility of restenosis. Despite the success of surgery, the percentage of relapses is still high, so we propose our own modification of the existing technique, which reduces the number of re-operations to 10%. Existing types of stenting materials of the EAC are considered. The use of stents allows you to keep the size of the EAC after surgery. The variants of conservative treatment are given: injectable glucocorticosteroids, growth factors, promising drugs, laserotherapy. Despite the achievements of modern medicine, the problem of repeated occurrence of atresia remains relevant and requires further development of integrated approaches in its treatment.

About the authors

I. A Anikin

Saint Petersburg Research Institute of Ear, Nose, Throat and Speech of the Ministry of Health of the Russian Federation

Email: dr-anikin@mail.ru
д-р мед. наук, проф., рук. отд. разработки и внедрения высокотехнологичных методов лечения 190013, Russia, Saint Petersburg, ul. Bronnitskaia, d. 9

S. A Eremin

Saint Petersburg Research Institute of Ear, Nose, Throat and Speech of the Ministry of Health of the Russian Federation

Email: 7shans@mail.ru
канд. мед. наук, науч. сотр. отд. разработки и внедрения высокотехнологичных методов лечения 190013, Russia, Saint Petersburg, ul. Bronnitskaia, d. 9

A. E Shinkareva

Saint Petersburg Research Institute of Ear, Nose, Throat and Speech of the Ministry of Health of the Russian Federation

Email: kilo-muza@rambler.ru
ординатор отд. разработки и внедрения высокотехнологичных методов лечения 190013, Russia, Saint Petersburg, ul. Bronnitskaia, d. 9

References

  1. Аникин И.А., Еремин С.А. Особенности приобретенных атрезий перепончато-хрящевого отдела наружного слухового прохода и эффективность нового хирургического лечения. РМЖ. 2017; 23: 1703-6
  2. Namystowski G, Scierski W, Mr6wka-Kata K et al. Surgical treatment of acquired external auditory canal atresia. Otolaryngol Pol 2002; 56 (1): 63-7.
  3. Droessaert V, Vanspauwen R, Offeciers E et al. Surgical Treatment of Acquired Atresia of the External Auditory Ear Canal. Int Arch Otorhinolaryngol 2017; 21 (4): 343-6.
  4. Munteanu A.D., Bedereag Helvetica Light I, NiHelvetica Lightescu C, Florescu I.P. Anatomo-pathological findings in scar: comparative study between different specimens. Rom J Morphol Embryol 2015; 56 (1): 283-8.
  5. Bonding P, Tos M. Postinflammatory acquired atresia of the external auditory canal. Acta Otolaryngol 1975; 79: 115-23.
  6. Luong A, Roland P.S. Acquired external auditory canal stenosis: assessment and management. Cur Opin Otolaryngol Head Neck Surg 2005; 13 (5): 273-6.
  7. Rex S. Haberman I.I. Middle ear and mastoid surgery. New York: Thieme, 2004; p. 177-88.
  8. Tos M. Руководство по хирургии среднего уха. Т. 3. Томск: СибГМУ, 2007.
  9. Paparella M.M, Kurkjain J.M. Surgical treatment for chronic stenosing external otitis. Laryngoscope 1966;56:232-45.
  10. Dhooge I, D'hoop M, Loose D, Acke F. Acquired atresia of the external auditory canal: long-term clinical and audiometric results aftersurgery. Otol Neurotol 2014; 35 (7): 1196-200.
  11. Jacobsen N, Mills R. Management of stenosis and acquired atresia of the external auditory meatus. J Laryngol Otol 2006; 120 (4): 266-71.
  12. Steffensen W.H. A method of correcting atresia of the ear canal. J Plast Reconstr Surg 1946;1: 329-31.
  13. Eichel B.S, Simonton K.M. Stenosis of the external auditory meatus secondary to chronic external otitis treated by a simplified surgical method: report of case. Laryngoscope 1965; 75: 16-21.
  14. Chao-Yin Kuo, Hsin-Chien Chen, Cheng-Ping Shih, Chih-Hung Wang. A Composite Foley Catheter Stent Used to Successfully Manage Recurrent Canal Stenosis Caused by Fibrous Dysplasia of the Temporal Bone. J Int Adv Otol 2014; 10 (2): 194-6.
  15. Keller R.G., Ong A.A, Nguyen S.A. et al. Postinflammatory medial canal fibrosis: An institutional review and meta-analysis of short- and long-term outcomes. Laryngoscope 2017; 127 (2): 488-95.
  16. Bajin M.D., Yilmaz T, Giinaydin R.O. et al. Management of Acquired Atresia of the External Auditory Canal. J Int Adv Otol 2015; 11 (2): 147-50.
  17. Еремин C.A., Аникин М.И., Салихова Г.С. Способ хирургического лечения приобретенной мягкотканой атрезии костного отдела наружного слухового прохода. Материалы V Петербургского форума оториноларингологов России и IV Всероссийского конгресса по слуховой имплантации с международным участием. 2016; с. 97-8.
  18. Аникин И.А., Еремин С.А., Салихова Г.С. Способ хирургического лечения приобретенных атрезий перепончато-хрящевого отдела наружного слухового прохода. Материалы XIX Съезда оториноларингологов России. 2016; с. 208-9.
  19. Астащенко С.В., Аникин И.А., Еремин С.А., Аникин М.И. Способ устранения латерализации неотимпанальной мембраны у пациентов, перенесших тимпанопластику. Рос. оториноларингология. 2012; 2 (57): 19-23.
  20. Tziotzios C, Profyris C, Sterling J. Cutaneous scarring: Pathophysiology, molecular mechanisms, and scar reduction therapeutics. Part II. Strategies to reduce scar formation after dermatologic procedures. J Am Acad Dermatol 2012; 66 (1): 13-24; quiz 25-6.
  21. Stojadinovic O, Lee B, Vouthounis C et al. Novel genomic effects of glucocorticoids in epidermal keratinocytes: inhibition of apoptosis, interferon-gamma pathway, and wound healing along with promotion of terminal differentiation. J Biol Chem 2007; 282: 4021-34.
  22. Trisliana Perdanasari A, Torresetti M, Grassetti L et al. Intralesional injection treatment of hypertrophic scars and keloids: a systematic review regarding outcomes. Burns Trauma 2015; 26 (3): 14.
  23. Khan M.A., Bashir M.M., Khan F.A. Intralesional triamcinolone alone and in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scars. J Pak Med Assoc 2014; 64 (9): 1003-7.
  24. Maguire H.C. Jr. Treatment of keloids with triamcinolone acetonide injected intralesionally. JAMA 1956; 192: 325-6.
  25. Adhershitha A.R., Anilkumar S, Rajesh C, Mohan D.C. Prosthetic management of posttraumatic external auditory canal atresia: A rare cause of conductive hearing loss. J Indian Prosthodont Soc 2016; 16 (4): 390-4.
  26. Tirelli G, Nicastro L, Gatto A, Boscolo F. Strenching stenosis of the external auditory canal: report of four causes and brief review of the literature. Acta Otorhinolaryngol Ital 2015; 35 (1): 34-8.
  27. Berman B, Perez O.A, Konda S et al. A review of the biologic effects, clinical efficacy, and safety of silicone elastomer sheeting for hypertrophic and keloid scar treatment and management. Dermatol Surg 2007; 33: 1291-303.
  28. Lecl F.M., Mordon S.R. Twenty-five years of active laser prevention of scars: what have we learned. J Cosmet Laser Ther 2010; 12: 227-34.
  29. Alster T.S, Williams C.M. Treatment of keloid sternotomy scars with 585 nm flashlamp-pumped pulsed-dye laser. Lancet 1995; 345: 1198-200.
  30. Occleston N.L, Fairlamb D, Hutchison J et al. Avotermin for the improvement of scar appearance: a new pharmaceutical in a new therapeuticarea. Expert Opin Investig Drugs 2009; 18 (8): 1231-9.
  31. Viera M.H, Amini S, Valins W, Berman B. Innovative therapies in the treatment of keloids and hypertrophic scars. J Clin Aesthet Dermatol 2010; 3: 20-6.
  32. Lo J.F., Tsang W.S., Yu J.Y. et al. Contemporary hearing rehabilitation options in patients with aural atresia. Biomed Res Int 2014; 2014: 761579.
  33. Farnoosh S, Mitsinikos F.T., Maceri D, Don D.M. Bone-anchored hearing aids vs. reconstruction of the external auditoary canal in children and adolescents with congenital aural atresia: a comparison study of outcomes. Front Pediatr 2014; 2: 1-7
  34. Manrique M, Sanhueza I, Manrique R, de Abajo J. A new bone conduction hearing implant: surgical tecnique and results. Otol Neurotol 2014; 35 (2): 216-20.
  35. Chihiro M, Tadashi N, Hiroshi H et al. Sound transmission by cartilage conduction in ear with fibrotic aural atresia. J Rehabil Res Dev 2014; 51 (2): 325-32.
  36. Shimokura R, Hosoi H, Iwakura T et al. Development of monaural and binaural behind-the-ear cartilage conduction hearing aids. Appl Acoust 2013; 74 (11): 1234-40.

Copyright (c) 2018 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies