Lateral Stenosis of External Auditory Canal Secondary to Corrosive acid Injury: A Rare Case Report and Review of Literature

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3889-3894. doi: 10.1007/s12070-023-03941-9. Epub 2023 Jun 14.

Abstract

Acquired external auditory canal (EAC) stenosis is an uncommon condition with an incidence of 0.6 in 100,000 population. Road traffic accidents and otology surgeries are the frequently reported causes for it to occur. The high rate of restenosis makes this condition difficult to manage. A 50 year old lady presented with history of accidental instillation of acid in her left ear at 6 months of age by the care giver. The patient developed stenosis of left EAC with hearing loss. Examination revealed pin point stenosis of left EAC. Puretone audiogram revealed a moderately severe conductive hearing loss. Computed tomogram showed soft tissue lesion obliterating the entire EAC and extending into the middle ear and antrum. Intra operatively only the cartilaginous EAC was stenosed. Surgical excision of the fibrotic scar with a tympanomastoidectomy and wide meatoplasty was done. Regular post operative aural toileting, packing with merocele strips and application of topical antibiotic -steroid preparations was done. 6 months post-surgery a patent EAC and healed tympanic membrane was achieved. In this report, we present a rare case of lateral EAC stenosis secondary to corrosive acid injury, highlighting the surgical steps, post operative care and surgical outcomes. A limited review of literature is also presented.

Keywords: Corrosive acid injury; Excision; External auditory canal; Stenosis; Stents; Surgery; Tympanomastoidectomy.