Tympanic plate fractures are uncommon injuries and carry the risk of external auditory canal stenosis. These injuries are often associated with fractures of adjacent bones like the mandible, maxilla, and temporal bone. Isolated bilateral tympanic bone fractures have rarely been reported. The most frequently advocated treatment for these injuries is surgical to prevent canal stenosis in the future. The effectiveness of non-operative management has been seldom reported. In the current case report, we present an uncommon injury with isolated bilateral tympanic plate fractures secondary to trauma to the mandible with no associated mandible or condylar fractures that were treated non-operatively. The functional outcomes were favorable at one year of follow-up.

OBJECTIVE: To discuss the treatment of external auditory canal stenosis or atresia occurring as a complication of transcanal endoscopic ear surgery.
METHODS: We retrospectively analyzed the medical records of 11 patients who developed external auditory canal stenosis or atresia after undergoing transcanal endoscopic ear surgery. The 10 patients with stenosis were treated with external auditory canal expansion via drainage tube insertion; 2 of these patients further received local injections of triamcinolone acetonide. One patient with atresia was treated with meatoplasty surgery followed by tube insertion and triamcinolone acetonide injection.
RESULTS: The stenosis/atresia improved in all patients, and the external auditory canal was unobstructed without restenosis.
CONCLUSIONS: Stenosis/atresia of the external auditory canal after transcanal endoscopic ear surgery should be treated with dilation therapy/meatoplasty in a timely manner to prevent progressive hyperplasia of the scar and regain a normal-sized ear canal.

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Medical topic therapies can relieve symptoms associated with lichen planus of external auditory canal. Further, bone-anchored hearing devices represent an optimal solution for hearing restoration in otic lichen planus.

The aim of study is to investigate the risk of developing acquired cholesteatoma and external auditory canal (EAC) stenosis after traumatic brain injury (TBI) from the Taiwan National Health Insurance Research Database (NHIRD). Each subject was individually traced from their index date to identify those who received a diagnosis of acquired cholesteatoma and EAC stenosis. Cox regression analyses were applied to determine the risk of TBI-related acquired cholesteatoma and EAC stenosis. The follow-up data collected over 10 years were obtained from the TBI and comparison cohorts, of 455,834 and 911,668 patients, respectively. Multivariate analysis demonstrated that TBI significantly increased the risk of cholesteatoma (adjusted hazard ratio (HR), 1.777; 95% confidence interval (CI), 1.494-2.114, p < 0.001) and EAC stenosis (adjusted (HR), 3.549; 95% (CI), 2.713-4.644, p < 0.001). In our subgroup injury analysis, falls had the highest associated risk (4.308 times), followed by traffic injuries (66.73%; 3.718 times that of the control group). Otolaryngologists should not neglect the clinical importance and carefully investigate the possibility of subsequent cholesteatoma and EAC stenosis, which leads to hearing impairment in patients with TBI. Our research also shows the important role in preventing TBI, especially as a result of traffic injuries and falls.

Congenital external auditory canal stenosis (EACS) is a spectrum of abnormalities affecting the external and middle ear. We report a 6 year-old patient with EACS affecting the lateral fibrocartilaginous canal that was successfully repaired. This patient highlights a variant of EACS characterized by lateral soft tissue narrowing with normal osseous development. Most previous studies of CAA have described severe forms associated with complete atresia, bony stenosis, and middle ear malformations. Stenosis affecting only the fibrocartilaginous canal is a milder form resulting from premature arrest of the canalization process during embryologic development, and may predispose to cholesteatoma formation.

Background: The surgical treatment of external auditory canal stenosis (EACS) and lateralized tympanic membrane (LTM) is challenging because there is a high risk of postoperative complications.Objectives: The aim of this study was to evaluate the postoperative hearing levels and other outcomes of 10 cases with EACS and LTM.Materials and methods: This was a retrospective preliminary study of patients with EACS and LTM who underwent meatotympanoplasty from 2008 to 2018. Their mean age at surgery was 31.6 years. The surgeries were performed taking into consideration the following: (1) creating a large EAC and functioning tympanic membrane (TM) and (2) avoiding complete mastoidectomy to prevent postoperative cavity problems.Results: The mean follow-up period was 3 years 10 months. The average preoperative and postoperative air-bone gaps (ABGs) were 40.4 dB and 23.0 dB, respectively, and there was a significant difference. A postoperative ABG less than 30 dB was achieved in 80% (8/10) of patients. Four cases had postoperative complications (re-stenosis of the EAC and/or re-lateralization of the TM).Conclusions and significance: The postoperative results presented were comparable to those of previous surgical techniques; however, further development is needed to prevent postoperative complications and earn better hearing results.

Acquired stenosis of the external auditory canal may be caused by a variety of insults, all sharing a common pathogenesis, namely a cascade of inflammatory changes leading to medial canal fibrosis. Previous surgery (canaloplasty or meatoplasty) and radiotherapy, especially if associated with a history of parotid surgery extended to the external auditory canal, have been implicated as possible causes. The literature offers advice on the management of stenosis consequent to otosurgery for congenital and acquired defects, but nothing on forms secondary to radiotherapy to the head and neck region. The proposed solutions are often cumbersome and difficult to fabricate, and therefore expensive. The aim of this paper, in which the cases of four patients are reported, is to present a new technique initially used for the most severe form - i.e. external auditory canal stenosis after surgery and radiotherapy - and then extended to forms due to different causes. This new technique involves the use of a series of surgical steel tubes of increasing dimension commonly used for tissue expansion in a body piercing practice called stretching and known as ear stretching tunnels or ear stretchers. This innovative approach proved effective in solving external auditory canal stenosis in our patients, with the least discomfort for the patient and the lowest cost. We consider this new solution to be feasible and practical and are convinced that it provides a new approach to an old problem. Further studies are needed to increase the number of clinical cases to verify how long the ear stretcher should be kept in place for the stenosis to stabilise, and to establish whether surgery is always necessary after ear stretcher application and, if so, the best timing for surgery.
La stenosi acquisita del condotto uditivo esterno (CUE) può essere causata da molti insulti con una patogenesi comune che è rappresentata da una cascata di alterazioni infiammatorie che portano alla fibrosi della porzione mediale del condotto. Un precedente intervento chirurgico, cioè canoloplastica o meatoplastica e la radioterapia (RT), soprattutto se associata con precedente chirurgia parotidea estesa al CUE, sono state messe in relazione a questo problema. In Letteratura abbiamo trovato consigli su come gestire le stenosi conseguenti a otochirurgia per difetti congeniti e acquisiti, ma nulla per quelle secondarie a radioterapia applicata al distretto testa e collo; le soluzioni proposte, spesso non sono maneggevoli e sono difficili da fabbricare, perciò sono costose. Il nostro obiettivo è quello di presentare, attraverso l\'esposizione dei casi di quattro pazienti, un nuovo metodo utilizzato per la prima volta per la condizione peggiore, ovvero stenosi del condotto uditivo esterno dopo intervento chirurgico e radioterapia, e poi esteso anche alla stenosi di origine diversa. Questa nuova tecnica utilizza una serie di tubi di acciaio chirurgico di diametro crescente solitamente usati in una pratica di espansione cutanea del body piercing chiamata \"stretching\" e conosciuti come \"ear stretching tunnels\" o \"ear stretchers\". Questo approccio innovativo si è dimostrato efficace nel risolvere la stenosi del condotto uditivo esterno nei nostri pazienti, con il più basso costo e il minimo disagio per il paziente. Pensiamo che questa nuova soluzione sia pratica e dimostri come il contributo di tutti sia essenziale nella ricerca di nuovi approcci a vecchi problemi. Ulteriori studi sono necessari per aumentare il numero di casi clinici, per verificare quanto tempo lo \"stretcher\" debba essere mantenuto in sede ovvero in quanto tempo la stenosi si stabilizza, in modo da definire se l\'intervento sia sempre necessario dopo l\'applicazione dello \"stretcher\" e quale sia il momento giusto per effettuarlo.