Acquired atresia of the external auditory canal and canaloplasty with Thiersch graft reconstruction: outcomes and complications

Acquired atresia of the external auditory canal (EAC) is a rare disease characterized by otorrhea and progressive hearing loss. Clinically,it is differentiated into two stages: the wet stage and the dry stage. The dry stage does not respond to pharmacological treatment andhas to be treated surgically. One surgical option is canaloplasty of the EAC with Thiersch graft reconstruction. This study aimed toreport the follow-up outcomes (otomicroscopic signs and pure tone audiometry [PTA]) in patients with acquired atresia treated withthis technique. Eighteen adult patients surgically treated for acquired atresia of the EAC between 2010 and 2020 were enrolled. Allunderwent canaloplasty with Thiersch graft reconstruction by one senior surgeon. Otomicroscopy and PTA results were evaluatedbefore and after surgery. Postsurgical follow-up was performed at 1–3–6–12 months and then annually. Presurgical otomicroscopicexamination revealed stenosis that occluded more than 75% of the EAC in all patients, and preoperative PTA showed conductivehearing loss in 89% of patients. However, postsurgical otomicroscopic examination showed that 94% of patients had a normal EACdiameter after one year, and only one patient had anterior blunting and recurrent atresia. In addition, postsurgical PTA evidenced anormal range in 89% of patients after one year. In conclusion, acquired atresia of the EAC is a troublesome disease usually associatedwith hearing loss. Therefore, treatment is chosen to resolve its symptoms. The results demonstrate evidence that canaloplasty withThiersch graft may be a suitable surgical method considering the lower incidence of recurrence and the excellent hearing outcomes.