Acquired External Auditory Canal Atresia: A Comparison of Acellular Dermal Matrix and Split-thickness Skin Grafting Techniques

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Abstract

Objective:

To describe the use of acellular dermal matrix (ADM) in the repair of acquired external auditory canal atresia (AEACA), and compare surgical results to AEACA repair by split-thickness skin grafting (STSG).

Study Design:

Retrospective chart review.

Setting:

Neurotology clinical practice.

Patients and Intervention:

From 2007 to 2015, 25 AEACA surgeries (8 ADM and 17 STSG) were identified meeting inclusion and exclusion criteria. Pre- and postoperative audiometric data with clinical follow-up were examined.

Outcome Measures:

Rate of external auditory canal restenosis, improvement of conductive hearing loss, and resolution of otorrhea.

Results:

Both surgical groups had similar preoperative air bone gaps (ABG). Mean follow-up was 24 months. There was no significant difference in restenosis rates between the ADM (13%, n = 1/8) and STSG (12%, n = 2/17) groups. ABG improved from 28 dB to 11 dB in the ADM group and from 24 dB to 9 dB in the STSG group. ABG closure with surgery was statistically significant (p < 0.05), but there was no difference between the two groups. There was no significant reduction of otorrhea.

Conclusion:

Acellular dermal matrix grafting has not been previously reported for use in AEACA repair, and is a reasonable alternative to STSG with similar hearing, restenosis, and otorrhea outcomes.

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