Introduction: Congenital anomalies involving the first branchial cleft are uncommon and may occasionally present as a duplicated external auditory canal. These developmental disruptions, stemming from incomplete closure of the cleft during embryogenesis, can result in symptoms such as chronic otorrhea, recurrent external ear infections, and varying degrees of hearing impairment. Case Presentation: We describe a male infant, aged 18 months, who exhibited an accessory external auditory canal along with a cutaneous tag near the right ear opening. Audiological assessments, including auditory brainstem response (ABR), identified mild conductive hearing loss in the right ear and moderate to severe mixed-type hearing loss on the left. These findings highlight the diagnostic value of early hearing evaluations in patients with rare congenital ear malformations. Conclusions: Duplication of the external auditory canal is a rare but clinically significant condition with potential for substantial auditory compromise. Prompt recognition and regular hearing assessments are essential to guide appropriate interventions. Depending on the anatomical and functional severity, management options may include surgical correction and hearing rehabilitation strategies.

Aim: The purpose of this study was to investigate whether psychoacoustic parameters could be significantly influenced by the human ear canal and whether gender played a significant role in these effects. Methods: In this study, sixty participants were enrolled, with an equal distribution of 30 male and 30 female individuals. White and sinusoidal noises at 75, 85, and 95 dB as stimulus sound pressure levels (SSPLs). Psychoacoustic parameters such as loudness, sharpness, roughness, and fluctuation strength were measured both outside (cavum part of the external ear) and inside the right ear of each participant. These measurements were done using a circular-shaped microphone with a 2-mm diameter and Labview software. The duration for each measurement was 10 s. The independent sample t-test and repeated measures ANOVA test were employed for the statistical analysis in this study. The results indicated that the equality of means was rejected at a significance level of P < 0. 05. All statistical analyses were conducted using SPSS Version 26. Results: The mean age and standard deviation of all participants were 22. 77 ± 2. 60 years old. The comparison of psychoacoustic parameters in the exposure to different types of noises at various levels between genders showed no statistically significant differences (all P > 0. 05). For both sinusoidal noise and white noise at all three studied SSPLs, the differences in four psychoacoustic parameters between the outer and inner ears of the participants were not statistically significant (all P > 0. 05). Conclusion: Based on our findings, it seems that the human ear canal does not have any effect on psychoacoustic parameters, leading us to conclude that the ear canal does not contribute to noise-induced annoyance.

True branchial cleft anomalies are duplications of the membranous part of the external auditory canal, and they manifest clinically as cysts, sinuses, or fistulas. This fault may lead to external auditory canal stenosis and atresia. Because of misdiagnosis, management is often inadequate, recurrence is common and iatrogenic injuries of the facial nerve have been reported. This report features a case of microtia and congenital cholesteatoma with first branchial fistula. External auditory canal stenosis complicated by middle ear and external canal cholesteatoma but branchial fistula, opening in the zygomatic root and a sinus in the helical root may be the cause of this feature. Clinical features are described and the embryological relationship between the first branchial cleft anomaly and external canal atresia is discussed.

Introduction:First branchial cleft anomalies manifest with duplication of the external auditory canal.Case Report:This report features a rare case of microtia and congenital middle ear and canal cholesteatoma with first branchial fistula. External auditory canal stenosis was complicated by middle ear and external canal cholesteatoma, but branchial fistula, opening in the zygomatic root and a sinus in the helical root, may explain this feature. A canal wall down mastoidectomy with canaloplasty and wide meatoplasty was performed. The branchial cleft was excised through parotidectomy and facial nerve dissection.Conclusion:It should be considered that canal stenosis in such cases can induce cholesteatoma formation in the auditory canal and middle ear.