Otology & Neurotology最新文献

{"title":"Changes in the Incidence of Pediatric Otitis Media Pre- and Post-COVID-19 Pandemic in South Korea: A Study Utilizing a HIRA-Customized Cohort for the Population Aged ≤18 Years.","authors":"Taeung Eom, Byungjun Jeong, Seok-Hyun Kim, Sung-Won Choi, Se-Joon Oh, Soo-Keun Kong, Il-Woo Lee, Hyun Min Lee","doi":"10.1097/MAO.0000000000004490","DOIUrl":"10.1097/MAO.0000000000004490","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the changes in the incidence of otitis media and ventilation tube insertion (VTI) rates among South Koreans aged ≤18 years since the COVID-19 pandemic and analyze the impact of social distancing and increased personal hygiene.</p><p><strong>Study design: </strong>A retrospective cohort study utilizing health insurance claim data.</p><p><strong>Setting: </strong>Healthcare facilities across South Korea.</p><p><strong>Patients: </strong>Individuals aged ≤18 years diagnosed with acute suppurative otitis media (AOM), chronic serous otitis media (SOM), or acute mastoiditis (AM).</p><p><strong>Intervention: </strong>Diagnostic and therapeutic interventions, including VTI procedures.</p><p><strong>Main outcome measure: </strong>Changes in the monthly average number of patients and episodes of AOM, SOM, and AM, and the number of VTI procedures, comparing pre-COVID-19 (2018-2019) to post-COVID-19 (January 2020-May 2021) periods.</p><p><strong>Results: </strong>The monthly average number of patients with AOM and number of episodes decreased by 56.6% and 62.9%, respectively (Estimate: 0.37 [95% CI: 0.30-0.46], p = 0.01) post-pandemic. SOM patients and episodes decreased by 58.2% and 61.2%, respectively (estimate, 0.39; 95% CI, 0.33-0.46; p = 0.01). AM patients and episodes decreased by 15.8% and 16.6%, respectively (estimate, 0.83; 95% CI, 0.69-1.00; p = 0.06). The monthly average number of VTI procedures for AOM and SOM also decreased significantly post-pandemic.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic led to a significant decrease in the incidence of otitis media and VTI surgeries in South Koreans aged ≤18 years. This decrease may be attributed to the implementation of social distancing measures and increased personal hygiene practices during the pandemic. These findings provide valuable insights for preventing and managing pediatric otitis media during future respiratory pandemics and similar public health emergencies.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"552-560"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Automated Cochlear Length and Cochlear Implant Insertion Angle Predictions with a Surgical Planning Platform.","authors":"Emilio Avallone, Max E Timm, Thomas Lenarz, Daniel Schurzig","doi":"10.1097/MAO.0000000000004480","DOIUrl":"10.1097/MAO.0000000000004480","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative anatomical assessment is essential to optimize the outcome of individualized cochlear implantation. Algorithms based on cochlear diameters simplify this evaluation. The new version of a surgical planning platform is capable of performing this determination automatically. Our study evaluated the robustness of automated measurements and compared individual differences between automated and manual measurements, including predicting cochlear duct length and insertion angles.</p><p><strong>Materials and methods: </strong>The preoperative cone beam CT scans of 55 MED-EL cochlear implant patients were analyzed. Using the surgical planning platform, the anatomical diameters were measured automatically and manually. The values were compared, as well as the predictions of the insertion angles and prediction of cochlear duct length.</p><p><strong>Results: </strong>The analyses showed good agreement between manual and automatic measurements of cochlear diameters, with the exception of cochlear height, where a significant difference was observed. Some discrepancies were noted for the prediction of the cochlear length duct without, however, a significant impact. Predictions of insertion angles based on automated measurements were comparable to the postoperative evaluations, with no significant difference from the manual ones.</p><p><strong>Discussion: </strong>The robustness of automated assessments is essential for integration into clinical practice. Automated measurements of cochlear dimensions are comparable to manual ones. However, image quality and the presence of anatomical abnormalities may influence the results. In this study, the evaluation of the insertion angle prediction was strengthened by comparison with postoperative results taking into account the actual insertion depth.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e161-e169"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RESPONSE TO LETTER TO THE EDITOR REGARDING: HEARING DEVICE COIL PLACEMENT LATERAL TO THE TEMPORALIS: AN ALTERNATIVE TO FLAP THINNING FOR COCHLEAR AND TRANSCUTANEOUS BONE-ANCHORED IMPLANTS.","authors":"Ashley M Nassiri, Cynthia A Hogan, Matthew L Carlson","doi":"10.1097/MAO.0000000000004478","DOIUrl":"10.1097/MAO.0000000000004478","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"606"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Customized Web Video-Based Vestibular Rehabilitation for Patients With Vestibular Hypofunction: A Randomized Controlled Study.","authors":"Tomohiko Kamo, Hirofumi Ogihara, Ryozo Tanaka, Masato Azami, Takumi Kato, Reiko Tsunoda, Hiroaki Fushiki","doi":"10.1097/MAO.0000000000004494","DOIUrl":"10.1097/MAO.0000000000004494","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of customized web video-based vestibular rehabilitation in patients with chronic vestibular hypofunction.</p><p><strong>Study design: </strong>This study is a randomized controlled trial.</p><p><strong>Setting: </strong>The dizziness specialty clinic.</p><p><strong>Patients: </strong>The participants were diagnosed with chronic vestibular hypofunction.</p><p><strong>Interventions: </strong>The study used a randomized controlled trial design, in which participants were randomly assigned to either the customized web video-based vestibular rehabilitation or booklet-based vestibular rehabilitation in a 1:1 ratio.</p><p><strong>Main outcome measures: </strong>Patients were assessed at three time points: before-intervention (baseline), post-intervention completion (6 wk), and follow-up (12 wk). The primary outcome was the Dynamic Gait Index (DGI), the secondary outcome was the Dizziness Handicap Inventory (DHI), and tertiary outcomes included other functional and psychological assessments.</p><p><strong>Results: </strong>The baseline characteristics of the patients were comparable between the two groups. Statistical analysis revealed a significant time effect for the DGI score ( p < 0.0001). Comparing the post-intervention and follow-up assessments to the baseline assessment, the customized web video-based VR group showed a significant increase in the DGI score. Time × group interaction effects were observed ( F = 5.739, p < 0.01). Both groups showed decreased DHI_total scores when comparing the postintervention and follow-up assessments to the baseline assessment. No serious adverse events were reported during intervention period.</p><p><strong>Conclusions: </strong>The present study demonstrated that customized web video-based VR improved DGI compared with booklet-based VR, and the intervention effect was maintained at 6-week follow-up. Additionally, the findings suggested that both interventions improve to a similar extent DHI. Therefore, vestibular rehabilitation with motion visualized by video may be more effective than that with still image by booklet.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"573-580"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologic Findings after Transpromontorial Approach: Clinical and Pathophysiological Considerations.","authors":"Matteo Alicandri-Ciufelli, Edoardo Serafini, Maria Rosini, Carlotta Liberale, Francesca De Cecco, Elke Loos, Paolo Garofalo, Nicolò Cardobi, Alessia Rubini, Daniele Marchioni","doi":"10.1097/MAO.0000000000004483","DOIUrl":"10.1097/MAO.0000000000004483","url":null,"abstract":"<p><strong>Objectives: </strong>Transpromontorial approaches require obliteration of the surgical cavity and the eustachian tube, along with cul-de-sac external auditory canal closure, without obliteration of the mastoid air cells. This study aims to evaluate the clinical and radiological implications of tympanic cavity obliteration when the mastoid air cell system is preserved.</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Thirty-one adult patients with unilateral vestibular schwannoma.</p><p><strong>Intervention: </strong>Patients underwent resection of a vestibular schwannoma through either an exclusive endoscopic transcanal transpromontorial approach (endoTTA) or an expanded transcanal transpromontorial approach (expTTA).</p><p><strong>Main outcome measure: </strong>Postoperative radiologic mastoid and surgical cavity content and clinical outcomes.</p><p><strong>Results: </strong>Thirty-one patients met the inclusion criteria. The mean radiological follow-up was 54 months. Regarding mastoid content, air was present in 13 patients (42%) and trapped fluid in 18 patients (58%). Surgical cavity content revealed air in 14 patients (45%), trapped fluid in 8 patients (26%), total fat obliteration in 5 patients (16%), and partial fat obliteration in 4 patients (13%). No cases of mucocele, cholesterol granuloma, or iatrogenic cholesteatoma were observed. Three main radiological patterns were identified by combining mastoid and surgical cavity findings. EndoTTA was found to be significantly associated with postoperative radiological air content in the mastoid cavity ( p value = 0.013), while no association was found between the type of radiological pattern and the development of complications or symptoms at the last follow-up.</p><p><strong>Conclusions: </strong>EndoTTA and expTTA are safe and effective procedures, with no increased risk of meningitis or CSF leak, even in cases where obliteration tissue is reabsorbed.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e176-e182"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Symptom Changes in Sporadic Vestibular Schwannoma: A Comparison of Observation, Microsurgery, and Radiosurgery.","authors":"Karl R Khandalavala, Christine M Lohse, Nicole M Tombers, Michael J Link, Matthew L Carlson","doi":"10.1097/MAO.0000000000004495","DOIUrl":"10.1097/MAO.0000000000004495","url":null,"abstract":"<p><strong>Objective: </strong>To compare differences in sporadic vestibular schwannoma (VS)-associated patient-reported symptom scores among patients receiving observation, microsurgery, or radiosurgery.</p><p><strong>Study design: </strong>Prospective longitudinal survey.</p><p><strong>Setting: </strong>Tertiary referral center and the national Acoustic Neuroma Association.</p><p><strong>Patients: </strong>Adults with sporadic VS.</p><p><strong>Intervention: </strong>Observation, microsurgery, or radiosurgery.</p><p><strong>Main outcome measure: </strong>Baseline and follow-up surveys on patient-reported severity of tinnitus, dizziness/imbalance, and headaches scored on a 10-point numeric scale, with higher scores indicating more severe symptoms; changes of 2 or more points from baseline were considered clinically important.</p><p><strong>Results: </strong>A total of 455 patients were eligible for study with a mean (SD) follow-up of 4.5 (2.4) years, including 122 (27%) managed with observation, 226 (50%) undergoing microsurgery, and 107 (23%) undergoing radiosurgery. Changes in tinnitus severity scores differed significantly among management groups ( p = 0.006), with severity scores increasing significantly in the radiosurgery (+0.8, p = 0.005) group but not in the observation (+0.2, p = 0.5) or microsurgery (-0.2, p = 0.18) groups. The changes in dizziness/imbalance and headache severity scores did not differ significantly among management groups. When comparing clinically important improvements (decrease of 2 or more points), the microsurgery and observation cohorts had a greater proportion of patients experiencing a clinically important improvement in tinnitus compared with the radiosurgery cohort; no other clinically important changes were significantly different among management groups.</p><p><strong>Conclusions: </strong>In this prospective study of 455 patients comparing patient-reported symptoms after VS management, radiosurgery was associated with worsening tinnitus severity scores overall and resulted in fewer patients reporting clinically important improvements in tinnitus compared with observation and microsurgery. As there was substantial variability in the effect of management modality on changes in symptom severity scores, possible treatment effects on subjective symptoms, including tinnitus, dizziness/imbalance, and headache, should not be used in isolation to inform clinical decision-making for management of sporadic VS.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"581-586"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auditory Characteristics in Children With Enlarged Vestibular Aqueduct.","authors":"Punam Patel, William Parkes, Cedric Pritchett, Matthew Stewart, Arabinda Choudhari, Rahul Nikam, Jobayer Hossain, Robert O'Reilly, Thierry Morlet","doi":"10.1097/MAO.0000000000004485","DOIUrl":"10.1097/MAO.0000000000004485","url":null,"abstract":"<p><strong>Objective: </strong>Enlarged vestibular aqueduct (EVA) is the most common radiographic finding in children diagnosed with congenital sensorineural hearing loss (SNHL). Many institutions use the Cincinnati criteria for diagnosis: width ≥2.0 mm at the operculum and/or ≥1.0 mm at the midpoint. Our goals are to expand our understanding of EVA by examining the audiometric and auditory brainstem response (ABR) characteristics of a large population of children with EVA and hearing loss.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Tertiary-care children's hospital.</p><p><strong>Patients: </strong>All children diagnosed with EVA from 2006 to 2016.</p><p><strong>Interventions: </strong>Diagnostic.</p><p><strong>Main outcome measures: </strong>Vestibular aqueduct measurements were taken at the operculum.</p><p><strong>Results: </strong>One hundred six patients were included (63 females; 60 bilateral EVA). The age of hearing loss diagnosis was significantly younger in patients with bilateral EVA compared with unilateral (0.0 [0-3] yr versus 5.0 [0.9-7.0] yr, p = 0.001). The most common pattern seen on ABR was SNHL-like (57%), followed by large wave I pattern (28.6%), followed by auditory neuropathy spectrum disorder (14.3%). Patients with bilateral EVA were more likely to have progressive hearing loss compared with patients with unilateral EVA ( p = 0.001). There was no correlation between EVA size and hearing stability or between EVA size and pure-tone average at the time of diagnosis.</p><p><strong>Conclusion: </strong>There is a wide range of clinical manifestations of EVA, though we found no significant correlation between size and progressiveness or severity. The clinical significance of a large wave I tracing on ABR is not fully understood and warrants further research.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"544-551"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Malleostapedotomy in Primary Stapes Surgery: Preliminary Results.","authors":"Zixuan Zhao, Yuqi Zhang, Xinyi Xue, Yuqi Feng, Margaret Sibeso Kamuwanga, Xi Wang, Xiaoyong Ren, Baojun Wu, Yang Li","doi":"10.1097/MAO.0000000000004499","DOIUrl":"10.1097/MAO.0000000000004499","url":null,"abstract":"<p><strong>Objective: </strong>To describe the surgical steps in endoscopic malleostapedotomy as a primary intervention and to evaluate the audiologic and surgical outcomes.</p><p><strong>Study design: </strong>Clinical capsule report.</p><p><strong>Setting: </strong>University hospital.</p><p><strong>Patients: </strong>Fourteen patients (10 males and 4 females) who underwent endoscopic malleostapedotomy as a primary intervention between April 2017 and July 2023 were enrolled in this study. Demographic data, surgical information, preoperative and postoperative pure-tone averages and air bone gaps, intraoperative and postoperative complications, and follow-up data were summarized and gathered in a database for further consideration and analysis.</p><p><strong>Results: </strong>During endoscopic ear surgery, congenital ossicular chain malformation was present in 13 cases and tympanosclerosis in 1 case. The postoperative air-bone gap improved significantly compared with the preoperative gap (18.4 versus 47.4 dB HL, respectively), and the mean air-bone gap closure was 29 dB HL. In 14% of cases, the observed postoperative air-bone gap was less than 10 dB HL, and in 64%, it was between 11 and 20 dB HL. An ABG closure lower than 20 dB HL was achieved in a total of 78% of patients. There was no sensorineural hearing loss or persistent vertigo in the study sample. Two cases of prosthesis too short or prosthesis extrusion occurred after a mean follow-up of 16.9 months.</p><p><strong>Conclusions: </strong>Endoscopic malleostapedotomy as a primary intervention is a safe and reliable procedure and is a technique of choice in selected cases of stapes fixation with incus anomaly.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e157-e160"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence Showing Three Layers of Reconstructed Tympanic Membrane After Second Regenerative Treatment.","authors":"Hiroshi Hidaka, Tomofumi Sakagami, Yuri Noda, Akihiro Shimamura, Hiroshi Iwai","doi":"10.1097/MAO.0000000000004421","DOIUrl":"10.1097/MAO.0000000000004421","url":null,"abstract":"<p><strong>Objective: </strong>To describe the case of a patient who twice underwent recently developed regenerative treatment for tympanic membrane perforation (RT-TMP), achieving successful regeneration of the TM consisting of three layers (epidermis, lamina propria, and mucosa) on pathological analyses of the regenerated part.</p><p><strong>Study design: </strong>Clinical capsule report.</p><p><strong>Patient: </strong>A 48-year-old woman with right chronic otitis media, showing a large TMP covering 80% of the total TM.</p><p><strong>Interventions: </strong>After the initial RT-TMP, the patient had a residual posterior TMP affecting 25% of the TM. At the second procedure, a portion of the previously regenerated TM was harvested for pathological analysis.</p><p><strong>Results: </strong>Pathological analysis of the surgical specimen showed that the regenerated TM tissue coandnsisted of three parts: outer epidermal, intermediate, and mucosal layers.</p><p><strong>Conclusion: </strong>By applying a recently developed RT-TMP, this report describes the first human study confirming the regeneration of the TM consisting of three layers (epidermis, lamina propria, and mucosa) on pathological analyses of the regenerated part at the second RT-TMP. This is a major step toward the goal of TM regeneration that recapitulates the structural properties of the native TM.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"521-524"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Results of Canalplasty Using a Pedicled Periosteal Flap for External Auditory Canal Cholesteatoma.","authors":"Yukiko Iino, Saori Seki, Tomonori Sugiyama, Saori Kikuchi","doi":"10.1097/MAO.0000000000004486","DOIUrl":"10.1097/MAO.0000000000004486","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the outcomes of canalplasty for external auditory canal cholesteatoma (EACC) using an inferior-pedicled periosteal flap to cover the eradicated diseased bone.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Thirty-one ears in 30 patients surgically treated for stages III and IV primary EACC.</p><p><strong>Intervention: </strong>Canalplasty using an inferior-pedicled periosteal flap with or without tympanoplasty.</p><p><strong>Main outcome measures: </strong>Disease recurrence, hearing, and clinical factors influencing the time taken to achieve complete epithelization of the external auditory canal.</p><p><strong>Results: </strong>The 31 ears with EACC required 2 to 40 weeks (mean, 7.8 wk; median, 4 wk) to achieve complete epithelization. After epithelization, 84% of the ears became self-cleaning ear canals without any local treatment. Two patients with renal dysfunction experienced recurrence of EACC in the anterior-superior bony canal wall and needed additional treatment. Younger patients took a significantly shorter time to achieve epithelization than older patients ( p < 0.001). Patients with renal dysfunction tended to need longer periods for epithelization than those without renal dysfunction ( p = 0.092).</p><p><strong>Conclusion: </strong>Canalplasty for stages III and IV EACC using an inferior-pedicled periosteal flap achieved good postoperative results, with 86% of ears becoming self-cleaning ear canals in a short healing time. Special attention must be paid to the patients with renal dysfunction to create a pedicled flap of sufficient size to cover the bone and maintain a good blood supply.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"539-543"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}