Quality of Life After Modified Rambo Ear Canal Closure in Pediatric and Adult Patients

Otolaryngol Head Neck Surg. 2023 Apr;168(4):814-820. doi: 10.1177/01945998221093529. Epub 2023 Feb 5.


Objective: To present the surgical and quality of life (QOL) outcomes of patients who underwent blind sac closure of the external auditory canal (EAC) via a modified Rambo approach.

Study design: Retrospective case review.

Setting: Tertiary academic referral center.

Methods: All patients who underwent EAC closure with a modified Rambo approach between 2015 and 2021 were evaluated. Complication rates, QOL estimations from a validated survey, and subjective cosmetic reports were analyzed.

Results: Thirty-five ears were closed in 31 patients. The most common indication for surgery was related to cochlear implantation and cochlear malformation or cholesteatoma (31.4%). No case involved an immediate complication requiring revision surgery, and 4 ears (11.4%) were suspected of having cholesteatoma within the surgical cavity at a mean 28.6-month follow-up. Adults (≥18 years) had significantly higher QOL scores than children in the medical resource subscale of the Chronic Ear Survey (P < .01), and patients undergoing concurrent EAC closure and skull base tumor removal scored higher than others (P = .04). Females reported higher cosmetic scores than males (P = .04). QOL and cosmetic scores compared favorably to previously published data involving the management of otologic disease.

Conclusions: Ear canal closure can be a useful technique for select adult and pediatric patients. Patient and surgeon concerns regarding QOL and cosmesis in ear canal closure should be explored prior to employing this surgical technique, though the present data suggest that the modified Rambo approach to closure is generally associated with reasonable outcomes in both areas.

Keywords: ear closure; modified Rambo; quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child
  • Cholesteatoma* / surgery
  • Cholesteatoma, Middle Ear* / surgery
  • Cochlear Implantation* / methods
  • Ear Canal / surgery
  • Female
  • Humans
  • Male
  • Mastoid / surgery
  • Otologic Surgical Procedures* / methods
  • Quality of Life
  • Retrospective Studies