From the Guidelines
Complications of canalplasty include tympanic membrane perforation, ear canal laceration, infection of the ear, and hearing loss, which can occur at a rate of about one in 1000 ear irrigations, as reported by 1 and 1.
Common Complications
- Tympanic membrane perforation: a serious complication that can result in hearing loss and may require further medical intervention, such as tympanoplasty, as noted in 1.
- Ear canal laceration: a potential complication that can cause pain, bleeding, and infection, and may require packing with gelfoam or other treatments, as mentioned in 1.
- Infection of the ear: a possible complication that can be managed with topical or oral antibiotics, such as ciprofloxacin, as discussed in 1.
- Hearing loss: a complication that can range from 5 to 40 dB, depending on the degree of occlusion of the canal with cerumen, as reported in 1.
Management of Complications
- Infection: typically managed with topical or oral antibiotics, such as ciprofloxacin 500mg twice daily for 7-10 days, as discussed in 1.
- Bleeding: usually resolves with pressure but may require packing with gelfoam if persistent, as mentioned in 1.
- Tympanic membrane perforation: typically heals spontaneously but occasionally requires tympanoplasty, as noted in 1.
Post-Operative Care
- Keeping the ear dry for 2-3 weeks, as discussed in 1.
- Antibiotic ear drops, such as ciprofloxacin 0.3% 4 drops twice daily for 7 days, as mentioned in 1.
- Regular follow-up to monitor healing and address complications early, as recommended in 1 and 1.
From the Research
Complications of Canalplasty
- The complications of canalplasty can be transient or permanent, and may include re-stenosis, facial palsy, and infection 2, 3.
- The re-stenosis rate has been reported to be around 4% in some studies, and is often associated with the use of a middle temporal artery flap 2.
- Partial, transient, delayed facial palsy has been reported to occur in around 2% of cases, and is thought to be related to thermal injury transmitted from the burr 2.
- Other complications that have been reported include poor wound healing, graft failure, and bleeding or discharge 4.
- The overall complication rate for canalplasty has been reported to be around 28% in some studies, although most of these complications are transient 3.
- The use of endoscopic techniques for canalplasty has been shown to result in significantly fewer minor postoperative complications compared to microscopic techniques 4.
Factors Influencing Complications
- Smoking has been shown to influence the rate of re-epithelialization after canalplasty, with smokers taking longer to heal 3.
- The surface area of the canal that needs to be re-epithelialized has also been shown to influence the rate of healing 3.
- The use of certain surgical techniques, such as the use of a middle temporal artery flap, has been associated with an increased risk of complications 2.
Management of Complications
- The management of complications after canalplasty will depend on the specific complication and the individual patient's needs 5, 2, 3, 4.
- In general, complications such as re-stenosis and facial palsy will require further surgical intervention, while minor complications such as poor wound healing and bleeding or discharge can be managed conservatively 2, 4.