Front Pediatr. 2026 May 14;14:1814290. doi: 10.3389/fped.2026.1814290. eCollection 2026.
ABSTRACT
BACKGROUND: Acquired external auditory canal stenosis (EACS) is a major cause of conductive hearing loss in children and adults, with multiple etiologies including otological surgical procedures, blunt trauma, and chronic inflammatory diseases, which can lead to persistent hearing loss and other adverse outcomes. Due to children’s unique anatomical fragility and strong tissue proliferative capacity, the clinical management of EACS remains challenging.This study aims to explore the clinical characteristics, optimal surgical approaches and prognostic factors of traumatic EACS in children, so as to provide evidence-based references for clinical practice.
METHODS: A retrospective medical record review was conducted for patients diagnosed with EACS who received treatment at The Second Xiangya Hospital between November 2020 and November 2025. Data were collected regarding age, gender, etiology, clinical symptoms, surgical methods, and postoperative outcomes. Descriptive statistics and Fisher’s exact test were used for data analysis.
RESULTS: The findings indicated that the characteristics of EACS in children were unilateral involvement (100%), with the primary etiologies being associated with prior ear surgeries (86%) and isolated hearing loss (100%). The postoperative recurrence rate was 57%, and all recurrent cases were accompanied by restenosis. In pediatric surgeries, the temporoparietal fascial flap was the most frequently utilized graft (43%), 43% of patients underwent conchal cartilage resection, and 86% received absorbable drug-eluting stent (DES) implantation. All patients adhered to a unified DES implantation and postoperative care protocol. Type I tympanoplasty (Wullstein classification) was carried out in one pediatric case and one adult case for tympanic membrane repair. The adult cohort exhibited multiple etiologies (50% related to prior ear surgeries, 17% post-trauma, 25% post-inflammation), frequent accompanying symptoms (25% with tinnitus, 50% with otorrhea, 17% with earache), a recurrence rate of 25%, and no postoperative restenosis. Statistical analysis verified that the restenosis rate in pediatric patients was significantly higher than that in adults (P = 0.012), and there was no significant correlation between recurrence and flap selection, cartilage resection, or DES implantation (all P > 0.05).
CONCLUSION: This study tentatively indicates that there exist disparities in the clinical characteristics of acquired external auditory canal stenosis between children and adults. The risk of postoperative restenosis in children is notably elevated, and this tendency might be associated with the inherent anatomical fragility and robust tissue proliferation capacity in children. Comprehensive preoperative imaging assessment, individualized surgical plan development, standardized drug-eluting stent implantation, structured long-term postoperative follow-up, and postoperative care may be conducive to enhancing the prognosis of acquired external auditory canal stenosis in children. Multicenter prospective studies with a larger sample size are required to further validate the optimal treatment strategy for acquired external auditory canal stenosis in children.
PMID:42220998 | PMC:PMC13216209 | DOI:10.3389/fped.2026.1814290
