ENT - September 2020 - 534

534

Figure 2. Defined measurement of OEAC in hourglass group. OEAC
indicates osseous external auditory canal.

The software used for statistical analysis was SPSS for Windows, version 17.0.1 (SPSS Inc, Chicago, Illinois).

Results
There were 62 patients with unilateral COM who underwent
tympanoplasty from 2011 to 2013 who were enrolled into the
COM group. The mean age of this group was 53.03 years
(range 18-84). Overall, there were slightly more female
patients than male patients (M/F: 22/40), and there was no
statistical difference between the sides of lesion ears (right/left
side: 28/34). Additionally, 53 patients received tympanoplasty
type I, 1 patient received classic type III tympanoplasty, and 8
patients received modified type III tympanoplasty.

Shape of the OEAC
The prevalence of different shapes of OEAC among total
patients, the COM group, and normal group was analyzed.
We found that cylindrical shape was the most common type
of OEAC shape of COM (36%), followed by conical (31%),
hourglass shape (27%), and reverse-conical shape (6%). A similar result was found in the control group and among total
patients. Neither the COM group nor the normal group had
ovoid shape of OEAC.

Dimensions of the OEAC
The dimensions of the OEAC at the first (isthmus/midcanal)
and the second (annular/membranous) section showed no statistical significance between lesion ears and normal ears within
the COM group (Table 1). In the normal group, the dimensions
of the OEAC also showed no significant difference between
bilateral ears (Table 2). We compared the 62 lesion ears in the
COM group with the 124 normal ears in the control group, and
there was no significant difference as to the dimensions of the
OEAC on axial and coronal images. We further divided

Ear, Nose & Throat Journal 99(8)

Figure 3. Defined measurement of OEAC in non-hourglass groupconical shape as example. OEAC indicates osseous external auditory
canal.

patients into hourglass and non-hourglass subgroups within the
COM and control cohorts. In the hourglass subgroup, there was
no difference between lesion ears in the COM group and normal ears in the control group. The same result could be seen in
the nonhourglass subgroups (Table 3).

Discussion
In several earlier studies8,9 the term ''canal stenosis'' was often
used to describe cases of ''canal atresia.'' However, these are 2
quite different entities. A canal atresia consists of a soft tissue
plug in the proximal portion of the EAC, attached to the lateral
surface of the tympanic membrane.1 The etiology may be traumatic,10 postoperative,11 neoplastic, or postinflammatory.12-13
A canal stenosis, on the other hand, is a narrowing of the dimension of the EAC that is either congenital or acquired. An
acquired canal stenosis (previously mentioned in the introduction section) can be secondary to persistent otitis externa,1,14
trauma (surgical or nonsurgical), malignancy,2 or irradiation.3
Although uncommon, COM has also been suggested to be
one of the proceeding conditions of acquired canal stenosis.1,4
The presence of canal stenosis secondary to COM causes several problems. First, the chronic discharging ear may become
difficult to treat locally, which results in higher failure rates
when only medical treatment is applied. Second, the narrowed
canal may cause hearing loss, and in some circumstances can
make hearing aid use difficult. Finally, the stenotic ear canal
may trap the keratin debris and, over time, can give rise to
cholesteatoma formation. Kimberley et al suggested that COM
is related to acquired canal stenosis. Typically, routine canaloplasty was required while performing tympanoplasty.4 The aim
of canaloplasty here was to produce a dry, patent ear canal and
to break the vicious cycle formed by COM and canal stenosis.
In the past decades, imaging of the temporal bone, particularly by HRCT, has played an increasingly important role for
diagnosis, surgical decision, and patient follow-up. Highresolution computed tomography can undoubtedly provide



ENT - September 2020

Table of Contents for the Digital Edition of ENT - September 2020

The Creation of a Sustainable Otolaryngology Department in Malawi Nathan Douglas Vandjelovic, Eric Masao Sugihara, Wakisa Mulwafu, and David Nathan Madgy
Hazardous Grilling Due to Wire Brushes Nima A. Vahidi, Brenna A. Keane, Paul J. Whalen, and Anita Jeyakumar
Guns n’ Noses: Endoscopic Removal of an Air-Gun Pellet Retained in the Frontal Sinus Dylan A. Levy, Andrew Y. Lee, Waleed M. Abuzeid, and Nadeem A. Akbar
Vitamin D Status in Egyptian Children With Allergic Rhinitis Khaled Saad, Abobakr Abdelmoghny, Mohamed Diab Aboul-Khair, Yasser Farouk Abdel-Raheem, Eman Fathalla Gad, Ahmed El-Sayed Hammour, Bahaa Hawary, Asmaa M. Zahran, Mohamd A. Alblihed, and Amira Elhoufey
Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017 Ying-Xia Lu, Jie-Qiong Liang, Qing-Long Gu, Chong Pang, and Chun-Lei Huang
Otomycosis With Tympanic Membrane Perforation: A Review of the Literature Petros Koltsidopoulos and Charalampos Skoulakis
Simultaneous Bilateral Same-Day Endoscopic Myringoplasty Using Tragal Cartilage From One Ear Baklaci Deniz, Kuzucu Ihsan, Guler Ismail, Kum Rauf Oguzhan, and Ozcan Muge
A Preliminary Report on the Investigation of Prestin as a Biomarker for Idiopathic Sudden Sensorineural Hearing Loss Changling Sun, Xiaolin Xuan, Zhi Zhou, Yuan Yuan, and Fei Xue
A Retrospective Study to Identify the Relationship Between the Dimension of Osseous External Auditory Canal and Chronic Otitis Media Yi-Fang Lee, Pei-Yin Wei, Chia-Huei Chu, Wen-Huei Liao, An-Suey Shiao, and Mao-Che Wang
Investigation of the Effectiveness of Surgical Treatment on Respiratory Functions in Patients With Obstructive Sleep Apnea Syndrome Burak Kersin, Murat Karaman, Engin Aynacı, and Ahmet Keles
Changing Trends of Color of Different Laryngeal Regions in Laryngopharyngeal Reflux Disease Chen Du, Paige Thayer, Yan Yan, Qingsong Liu, Li Wang, and Jack Jiang
ENT - September 2020 - Intro
ENT - September 2020 - Cover1
ENT - September 2020 - Cover2
ENT - September 2020 - 489
ENT - September 2020 - 490
ENT - September 2020 - 491
ENT - September 2020 - 492
ENT - September 2020 - 493
ENT - September 2020 - 494
ENT - September 2020 - 495
ENT - September 2020 - 496
ENT - September 2020 - 497
ENT - September 2020 - 498
ENT - September 2020 - 499
ENT - September 2020 - 500
ENT - September 2020 - The Creation of a Sustainable Otolaryngology Department in Malawi Nathan Douglas Vandjelovic, Eric Masao Sugihara, Wakisa Mulwafu, and David Nathan Madgy
ENT - September 2020 - 502
ENT - September 2020 - Hazardous Grilling Due to Wire Brushes Nima A. Vahidi, Brenna A. Keane, Paul J. Whalen, and Anita Jeyakumar
ENT - September 2020 - 504
ENT - September 2020 - Guns n’ Noses: Endoscopic Removal of an Air-Gun Pellet Retained in the Frontal Sinus Dylan A. Levy, Andrew Y. Lee, Waleed M. Abuzeid, and Nadeem A. Akbar
ENT - September 2020 - 506
ENT - September 2020 - 507
ENT - September 2020 - Vitamin D Status in Egyptian Children With Allergic Rhinitis Khaled Saad, Abobakr Abdelmoghny, Mohamed Diab Aboul-Khair, Yasser Farouk Abdel-Raheem, Eman Fathalla Gad, Ahmed El-Sayed Hammour, Bahaa Hawary, Asmaa M. Zahran, Mohamd A. Alblihed, and Amira Elhoufey
ENT - September 2020 - 509
ENT - September 2020 - 510
ENT - September 2020 - 511
ENT - September 2020 - 512
ENT - September 2020 - Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017 Ying-Xia Lu, Jie-Qiong Liang, Qing-Long Gu, Chong Pang, and Chun-Lei Huang
ENT - September 2020 - 514
ENT - September 2020 - 515
ENT - September 2020 - 516
ENT - September 2020 - 517
ENT - September 2020 - Otomycosis With Tympanic Membrane Perforation: A Review of the Literature Petros Koltsidopoulos and Charalampos Skoulakis
ENT - September 2020 - 519
ENT - September 2020 - 520
ENT - September 2020 - 521
ENT - September 2020 - Simultaneous Bilateral Same-Day Endoscopic Myringoplasty Using Tragal Cartilage From One Ear Baklaci Deniz, Kuzucu Ihsan, Guler Ismail, Kum Rauf Oguzhan, and Ozcan Muge
ENT - September 2020 - 523
ENT - September 2020 - 524
ENT - September 2020 - 525
ENT - September 2020 - 526
ENT - September 2020 - 527
ENT - September 2020 - A Preliminary Report on the Investigation of Prestin as a Biomarker for Idiopathic Sudden Sensorineural Hearing Loss Changling Sun, Xiaolin Xuan, Zhi Zhou, Yuan Yuan, and Fei Xue
ENT - September 2020 - 529
ENT - September 2020 - 530
ENT - September 2020 - 531
ENT - September 2020 - A Retrospective Study to Identify the Relationship Between the Dimension of Osseous External Auditory Canal and Chronic Otitis Media Yi-Fang Lee, Pei-Yin Wei, Chia-Huei Chu, Wen-Huei Liao, An-Suey Shiao, and Mao-Che Wang
ENT - September 2020 - 533
ENT - September 2020 - 534
ENT - September 2020 - 535
ENT - September 2020 - 536
ENT - September 2020 - Investigation of the Effectiveness of Surgical Treatment on Respiratory Functions in Patients With Obstructive Sleep Apnea Syndrome Burak Kersin, Murat Karaman, Engin Aynacı, and Ahmet Keles
ENT - September 2020 - 538
ENT - September 2020 - 539
ENT - September 2020 - 540
ENT - September 2020 - 541
ENT - September 2020 - 542
ENT - September 2020 - Changing Trends of Color of Different Laryngeal Regions in Laryngopharyngeal Reflux Disease Chen Du, Paige Thayer, Yan Yan, Qingsong Liu, Li Wang, and Jack Jiang
ENT - September 2020 - 544
ENT - September 2020 - 545
ENT - September 2020 - 546
ENT - September 2020 - 547
ENT - September 2020 - 548
ENT - September 2020 - 549
ENT - September 2020 - 550
ENT - September 2020 - 551
ENT - September 2020 - 552
ENT - September 2020 - Cover3
ENT - September 2020 - Cover4
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