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섬유성 이형성증에 의한 외이도 폐쇄증: 측두근막과 피부 복합 이식으로 폐쇄성형술을 시행한 1예

A case of external auditory canal stenosis due to fibrous dysplasia treated by canaloplasty with temporalis fascia and skin composite graft

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대한두개저학회지 제20권 제2호.jpg

Fibrous dysplasia is a gradually progressive, benign fibro-osseous disorder that exhibits rare involvement in the temporal bones. In such instances, the predominant manifestation involves development of bony lesions originating from the osseous component of external auditory canal (EAC), potentially leading to EAC stenosis. Surgical intervention through canaloplasty, involving removal of the fibrous obstruction, enlargement of the EAC, and reconstruction of a new epithelized canal, is the preferred management. However, it is challenging to perform canaloplasty in cases of fibrous dysplastic conditions due to tumor-like growth tendencies. In this report, we present a case of a 15-yearold male who presented with progressive conductive hearing loss and was diagnosed as EAC stenosis and cholesteatoma associated with fibrous dysplasia. To prevent further deterioration of his hearing, the patient underwent canaloplasty using a post-auricular approach. The reconstruction of EAC was accomplished using deep temporalis fascia and a wedge-shaped full thickness skin graft obtained from the post-auricular skin. Following the surgery, the patient’s hearing was completely restored, and the newly reconstructed EAC showed satisfactory outcomes. This case highlights the successful management of a rare condition involving EAC stenosis and concomitant cholesteatoma caused by fibrous dysplasia through canaloplasty using full thickness skin and fascia graft.

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