Long-Term Surgical Outcome of Canal-Tympanoplasty in Patients With Schuknecht Type B Congenital Aural Stenosis

• Published in: Clinical and experimental otorhinolaryngology Vol. 18; no. 1; pp. 14 - 20
• Main Authors: Lee, Yoonjae, Park, Moo Kyun, Lee, Jun Ho, Lee, Sang-Yeon, Suh, Myung-Whan
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Otorhinolaryngology-Head and Neck Surgery 01.02.2025; 대한이비인후과학회
• Subjects: canal; congenital aural atresia; hearing; Original; patients; schuknecht; tympanoplasty; 이비인후과학; Congenital Aural Atresia; Hearing; Tympanoplasty; Patients; Canal; Schuknecht
• ISSN: 1976-8710; 2005-0720; 2005-0720
• DOI: 10.21053/ceo.2024.00189

Objectives. Congenital aural atresia (CAA) is a complex condition that manifests in various forms, including Schuknecht type B stenosis, which is characterized by a congenitally narrow bony external auditory canal (EAC). This study aims to evaluate the long-term surgical outcomes of canal-tympanoplasty in patients with Schuknecht type B CAA.Methods. The study included 21 ears diagnosed with Schuknecht type B CAA, all of which underwent canal-tympanoplasty. Reconstruction of the large EAC and tympanic membrane involved conchal flap meatoplasty, bony EAC drilling, ossicular reconstruction, and overlay tympanoplasty. Standard pure-tone audiometry was analyzed at multiple post-surgery time points: 3, 6, 12, and 24–60 months. Additionally, the incidence of postoperative complications was assessed.Results. The hearing outcomes of canal-tympanoplasty in this case series were satisfactory. Serviceable hearing was achieved in all patients after 3 months and was maintained in 85% of patients for 1 year. The air-bone gap improved from a preoperative average of 39.3±15.1 dB to 13.7±7.4 dB at 3 months, 16.4±10.5 dB at 6 months, 19.1±11.7 dB at 12 months, and 21.5±16.1 dB at 2–5 years postoperatively. Three patients required revision canal-tympanoplasty due to hearing deterioration, representing 14.3% of the cases. There were no instances of postoperative infection, facial nerve weakness, vertigo, deterioration of bone conduction thresholds, or complete restenosis of the EAC.Conclusion. Canal-tympanoplasty proved to be a satisfactory surgical intervention for patients with Schuknecht type B CAA. This procedure led to significant improvements in hearing outcomes, providing serviceable hearing that lasted for several years. Moreover, the risk of postoperative hearing deterioration and/or the need for revision surgery within 1 year was considered acceptable.