Hearing Outcomes After Surgical Repair for Posttraumatic External Auditory Canal Stenosis

Acquired external auditory canal (EAC) stenosis or atresia is commonly associated with chronic inflammation and postsurgical changes, whereas cases resulting from trauma are understudied. Previous reports have included heterogeneous cases, limiting prognostic clarity. We investigated audiometric and surgical outcomes in a homogeneous cohort of patients with post-traumatic EAC stenosis.

We retrospectively reviewed patients treated for posttraumatic EAC stenosis at a tertiary referral center between March 2012 and April 2025. All patients underwent modified meatocanaloplasty with full-thickness skin graft (FTSG) reconstruction using an endaural approach. To contextualize our findings, we reviewed studies of acquired EAC stenosis or atresia that reported extractable pre- and postoperative audiometric outcomes.

Nineteen patients (19 ears; mean age: 34.6 years) were included. The mean interval from trauma to surgery was 31.7 months, and the mean clinical follow-up period was 27.9 months. The mean air-conduction pure-tone average improved from 50.0 to 26.4 dB HL (p < 0.001), and the mean air-bone gap decreased from 31.6 to 7.3 dB (p < 0.001). Postoperative air-bone gap closure ≤ 20 dB was achieved in 17 patients (89.5%), and closure ≤ 10 dB in 14 (73.7%). No patient required revision for restenosis during follow-up. Among the studies included in the literature review, traumatic cases were uncommon. Postoperative hearing outcomes in our cohort compared favorably with previously published ranges.

In this posttraumatic EAC stenosis cohort, modified meatocanaloplasty with FTSG reconstruction via an endaural approach was associated with maintained canal patency and clinically meaningful hearing improvement.