Canalplasty
Canalplasty is a reconstructive ear procedure that enlarges, reshapes or reconstructs the external auditory canal to treat congenital stenosis, acquired narrowing from chronic infection or previous surgery, and to improve hearing and aural hygiene.
By removing bony or fibrous narrowing and resurfacing the canal, canalplasty restores a patent ear canal, enhances sound transmission and reduces recurrent infections or troublesome cerumen entrapment.
Overview And Clinical Background
Restoring canal patency for hearing and health
Canalplasty addresses functional obstruction of the external auditory canal due to congenital atresia/stenosis, chronic otitis externa with canal stenosis, exostoses or post-surgical scarring.
The operation improves ear hygiene, prevents recurrent infections and can be combined with hearing reconstruction when necessary.
Surgical planning considers skin coverage, preservation of canal lining, and the need for grafts to maintain long-term patency.
- Indications: Congenital canal atresia/stenosis, chronic canal scarring after infections, exostoses from cold-water exposure or iatrogenic narrowing.
- Functional aim: re-establish a wide, self-cleaning canal to reduce infections and permit reliable hearing aid fitting if required.
- Reconstructive focus: Combine bony work with soft-tissue resurfacing (skin grafts or flaps) to create a durable, epithelialised canal.
Symptoms, Signs And Presentation
Patients present with conductive hearing loss, recurrent ear discharge, ear fullness or difficulty with ear hygiene and hearing aid fitting.
In congenital cases, parents notice small or absent external ear openings or delayed auditory milestones in children.
- Common signs: Reduced hearing on affected side, recurrent otorrhea, impacted cerumen and persistent itching or discomfort.
- In congenital atresia: external canal absence or severe narrowing with variable middle ear involvement.
- Red flag: Persistent ear discharge despite topical therapy or sudden deterioration in hearing merits specialist review.
Diagnosis Methods And Investigations
Audiology and imaging for surgical planning
Assessment includes audiometry, otoscopic evaluation and CT imaging of the temporal bone to define bony anatomy, ossicular status and facial nerve position crucial for safe canal reconstruction.
Meticulous preoperative mapping guides the extent of bony work and grafting requirements.
- Audiometry: Pure-tone and speech audiometry quantify conductive loss and set expectations for hearing improvement.
- CT temporal bone: High-resolution CT to evaluate canal, mastoid and ossicular anatomy and to plan bony drilling safely.
- Otologic exam: assess skin quality, active infection and need for pre-op topical therapy.
Treatment Options And Surgical Techniques
Canalplasty under general anaesthesia involves removing bony overgrowth or stenotic bone, fashioning a widened canal and resurfacing with local skin flaps or full-thickness grafts.
When indicated, ossicular reconstruction or tympanoplasty can be performed concurrently to address conductive hearing loss.
- Bony work: Microsurgical drilling of stenotic canal bone or exostoses to create an adequate lumen while protecting the facial nerve and inner ear structures.
- Canal lining: Skin grafts, local flaps or split-thickness grafts are used to line the newly created canal to prevent restenosis.
- Combined procedures: tympanoplasty or ossiculoplasty performed when middle ear pathology contributes to hearing loss.
Recovery, Risks And Prognosis
Postoperative care includes pack removal, topical antibiotic/steroid drops, and regular aural toileting to ensure graft take and epithelialisation.
Risks include restenosis, infection, graft failure, altered sensation, or rare sensorineural hearing change.
With appropriate technique and follow-up, canalpatency and improved hearing are durable outcomes.
- Early recovery: Ear packing for 1–2 weeks, temporary hearing fluctuation, and local discomfort managed with analgesics.
- Follow-up: frequent clinic cleaning and microscopic inspection until canal epithelium matures over weeks to months.
- Long-term result: Sustained canal patency, fewer infections and potential improvement in conductive hearing when combined reconstruction is performed.
Why Choose Us
CureU Healthcare’s otology service combines high-resolution imaging, microsurgical expertise and meticulous postoperative care to deliver lasting canalplasty results.
Our team plans reconstruction tailored to anatomy and hearing needs, ensuring functional and cosmetic success.
Conclusion
Canalplasty restores a healthy, patent external auditory canal, reduces recurrent infections and often improves conductive hearing when combined with middle ear surgery.
With careful surgical technique and dedicated follow-up, patients achieve durable functional benefits and better ear health.
