An hourglass or funnel-shaped, stenosed, external auditory meatus with a normal tympanic membrane, middle and inner ear is one of the congenital anomalies that occasionally occurs.
Such abnormality was present in both ears of a woman and caused chronic otitis externa and deafness. A routine meatoplasty on the right ear failed because of an unusual cephalad position of the drumhead in relation to a "downhill" position of the stenosed outer meatus. Rerouting the ear canal to a horizontal position by removing bone of the canal superiorly, posteriorly, and inferiorly, and grafting the now horizontal canal with skin taken from the postauricular fold produced a good result.
This is a satisfactory procedure for a woman, but would be cosmetically unacceptable for a man.
Baron SH. Rerouting the External Auditory Canal: A Method of Correcting Congenital Stenosis. Arch Otolaryngol. 1975;101(4):238–240. doi:10.1001/archotol.1975.00780330034009
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