PMC9761233_01
Pure tone audiometry. (A) Preoperative audiogram: moderate-severe conductive
hearing loss. (B) Post-surgical audiogram: closure of the air-bone gap.
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Pure tone audiometry showed a bilateral conductive hearing loss, more severe in the right ear (Figure 1) due to the previous multiple episodes of external otitis in the acute phase of EB.
Preoperative Computed tomography. Arrows point at external auditory canal
stenosis.
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CT showed no significant alterations, except for stenosis of the ear canals (Figure 2).
Intraoperative view. (A) Excision of the stenotic tissue (white arrow) from
the external auditory canal. (B) Canaloplasty of the external auditory canal
(white arrows) that allows a better exposition of the tympanic membrane
(asterisk). (C) Positioning of the Thiersch graft (white arrow) in the
external auditory canal. (D) Correctly positioned Thiersch graft (white
arrow).
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Thiersch skin grafting (Figure 3). This approach was preferred to the endoauricolar one because it allowed a better view of the EAC and complete removal of external stenotic tissue and since plastic surgery for ear canal enlargement was a preventive measure for recurrence of ear canal stenosis.
Low-power magnification of the excised sample is shown in the top panel. Some
glandular ducts and the small epidermoid cyst (asterisk) associated with a
giant cell granuloma (arrow) are shown in the left and right bottom panels,
respectively.
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Indeed, the sample consisted of chronically inflamed dense connective tissue containing focally dilated glandular ducts and a small epidermoid cyst associated with a giant cell granuloma (Figure 4).