关键词: Conductive Ear canal Hearing loss Lichen planus Tympanomastoidectomy

Mesh : Disease Progression Ear Canal / pathology surgery Ear Diseases / complications pathology surgery Female Hearing Loss, Conductive / etiology Humans Hypertrophy Lichen Planus / complications pathology surgery Mastoid / surgery Middle Aged Otitis Externa / surgery Pruritus / etiology Recurrence Reoperation Tympanic Membrane / surgery

来  源:   DOI:10.1016/j.anorl.2017.12.013   PDF(Sci-hub)

Abstract:
BACKGROUND: We report a case of unilateral progressive primary hypertrophic lichen planus of the external auditory canal requiring several surgical interventions to deal with constant pruritus, otorrhoea, stenosis and conductive hearing loss.
METHODS: A 58-year-old woman was initially treated with meatoplasty for suspected chronic obliterating otitis externa. She remained symptom-free for 5 years, before the disease recurred, affecting other body surfaces as well. Otorrhoea, conductive hearing loss and pruritus worsened, and a canal wall down tympanomastoidectomy was performed, removing the skin of the external auditory canal and the tympanic membrane completely. Lichen planus was confirmed histopathologically.
CONCLUSIONS: Very few surgical results have been published on stenosis of the external auditory canal caused by lichen planus. Complete medial external auditory canal skin elevation and removal with postoperative split-skin grafting is advised for initial treatment. We discuss treatment options and surgical outcome after initial surgical failure.
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