Clinical Outcomes of the U-Linear Split Thickness Skin Graft Technique for Reconstruction for Ear Canal Stenosis

Document Type : Original

Authors

1 Department of Otorhinolaryngology, Khon Kaen Hospital, Khon Kaen, Thailand Department of Otorhinolaryngology, Buengkan Hospital, Buengkan, Thailand.

2 Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

3 Department of Otorhinolaryngology, Chaiyaphum Hospital, Chaiyaphum, Thailand.

10.22038/ijorl.2025.87421.3932

Abstract

Introduction:
Canaloplasty is challenging because of the high rate of postoperative restenosis. The aim of this study was to evaluate the outcomes of using a U-Linear split-thickness skin graft (U-Linear STSG), a novel modified graft placement technique for canaloplasty.
 Materials and Methods:
A retrospective cross-sectional study was conducted on patients who underwent canaloplasty between January 2013 and December 2023. The medical records of external auditory canal stenosis patients who underwent canaloplasty were reviewed. The data collected included patient demographics, surgical approaches, postoperative outcomes, and audiometric findings. The outcomes of reconstruction for ear canal stenosis using a U-Linear STSG were compared with those using a reconstructed local flap. Statistical analyses included chi-square tests for categorical data and independent t tests for continuous data.
Results:
Thirty-six patients with external auditory canal stenosis underwent reconstruction; 17 patients underwent reconstruction with a U-Linear STSG, and 19 patients underwent reconstruction with a local flap. A review of the clinical outcomes revealed that postoperative restenosis was significantly less common in the U-Linear STSG group than in the local flap group (p < 0.05). In terms of audiometry, the postoperative air‒bone gap in the U-STSG group was slightly greater than that in the local group. No serious complications were observed in either group.
Conclusion:
A U-Linear STSG can be simply and feasibly applied in reconstruction for ear canal stenosis, with no major complications.

Keywords

Main Subjects

References

  1. Becker BC, Tos M. Postinflammatory acquired atresia of the external auditory canal: treatment and results of surgery over 27 years. Laryngoscope. 1998;108(6):903-907. doi: 10.1097/00005537-199806000-00021.
  2. Mankekar G, Entezami P. Acquired Stenosis of the External Ear Canal. Otolaryngol Clin North Am. 2023;56(5):919-931. doi:10.1016/j.otc.2023.06. 012. 
  3. Lavy J, Fagan P. Chronic stenosing external otitis/postinflammatory acquired atresia: a review. Clin Otolaryngol Allied Sci. 2000;25(6):435-439. doi: 10.1046/j.1365-2273.2000.00388.x.
  4. Bonding P, Tos M. Postinflammatory acquired atresia of the external auditory canal. Acta Otolaryngol. 1975;79(1-2):115-123. doi: 10.3109/ 00016487509124663.
  5. Paparella MM, Kurkjian JM. Surgical treatment for chronic stenosing external otitis. (Including finding of unusual canal tumor). Laryngoscope. 1966; 76(2):232-245. doi: 10.1288/00005537-196602000-00004.
  6. Dhooge I, D'hoop M, Loose D, Acke F. Acquired atresia of the external auditory canal: long-term clinical and audiometric results after surgery. Otol Neurotol. 2014;35(7):1196-1200. doi: 10. 1097/ MAO. 0000000000000317. 
  7. Jacobsen N, Mills R. Management of stenosis and acquired atresia of the external auditory meatus. J Laryngol Otol. 2006;120(4):266-271. doi: 10. 1017/ S0022215106000272.
  8. Bajin MD, Yılmaz T, Günaydın RÖ, Kuşçu O, Sözen T, Jafarov S. Management of Acquired Atresia of the External Auditory Canal. J Int Adv Otol. 2015;11(2):147-150. doi: 10.5152/ iao. 2015. 461. 
  9. Cremers WR, Smeets JH. Acquired atresia of the external auditory canal. Surgical treatment and results. Arch Otolaryngol Head Neck Surg. 1993; 119(2):162-164. doi: 10.1001/ archotol. 1993. 01880140044007.
  10. Slattery WH 3rd, Saadat P. Postinflammatory medial canal fibrosis. Am J Otol.1997;18(3):294-297.
  11. McDonald TJ, Facer GW, Clark JL. Surgical treatment of stenosis of the external auditory canal. Laryngoscope. 1986;96(8):830-3. doi: 10. 1002/ lary.1986.96.8.830.
  12. Chen CK, Chang KP, Chien CY, Hsieh LC. Endoscopic transcanal removal of external auditory canal osteomas. Biomed J. 2021;44(4):489-494. doi: 10.1016/j.bj.2020.04.003.
  13. Bajin MD, Yılmaz T, Günaydın RÖ, Kuşçu O, Sözen T, Jafarov S. Management of Acquired Atresia of the External Auditory Canal. J Int Adv Otol. 2015;11(2):147-150. doi: 10.5152/ iao. 2015. 461.
  14. Ng CS, Foong SK, Loong SP, Ong CA, Hashim ND. A Novel Use of Modified Tracheostomy Tubes in Preventing External Auditory Canal Stenosis. J Int Adv Otol. 2021;17(4):301-305. doi: 10. 5152/ iao.2021.0078.
  15. Moon IJ, Cho YS, Park J, Chung WH, Hong SH, Chang SO. Long-term stent use can prevent postoperative canal stenosis in patients with congenital aural atresia. Otolaryngol Head Neck Surg. 2012; 146(4):614-620. doi: 10.1177/ 0194599811426257.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. Scaria SM, Tward AD. Endoscopic Medial Reepithelization for Inflammatory Canal Stenosis. Otol Neurotol. 2022;43(8):973-977. doi: 10. 1097/ MAO. 0000000000003625.
  2. Schwarz D, Luers JC, Huttenbrink KB, Stuermer KJ. Acquired stenosis of the external auditory canal - long-term results and patient satisfaction. Acta Otolaryngol. 2018;138(9):790-794. doi: 10. 1080/ 00016489.2018.1476779.
  3. Zou Y, Zhang M, Duan X, et al. New strategies and methods for reconstruction of the outer ear canal (OEC). Acta Otolaryngol.2023;143(sup1): S39-S44.doi: 10.1080/00016489.2023.2275610.
Iranian Journal of Otorhinolaryngology
Volume 37, Issue 6
November and December 2025
Pages 335-340

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