Transcanal Micro-Osteotome Only Technique for Excision of Exostoses

Otol Neurotol. 2016 Feb;37(2):185-9. doi: 10.1097/MAO.0000000000000934.

Abstract

Objectives: To evaluate the outcomes and complications of transcanal excision of exostoses using micro-osteotomes, without a postauricular incision or the use of the drill.

Study design: A retrospective chart review of patients undergoing exostoses excision.

Setting: Tertiary Care Medical Center.

Subjects and methods: All of the patients underwent surgical removal of the exostoses using only a 1 or 2 mm micro-osteotomes. Patients were followed postoperatively and associated complications were evaluated.

Results: One-hundred thirty-eight ears in 106 patients were treated for obstructive exostosis. The average age of patients was 43 ± 16 years. Of these, 99 were man (93%) and 7 were woman (7%). A majority of the patients (84%, n = 89) had 90 to 100% obstruction of the ear canal. Complete ear canal healing was observed in 80% of patients by 3 weeks. All but one patient had healed by 6 weeks postoperatively. There were 9 (6.5%) slit tympanic membrane perforations that healed with intraoperative gelfoam or fascia myringoplasty. One patient had an anterior canal mobilization which required Xeroform packing for 3 weeks for stabilization. There were no postoperative vertigo, facial paresis, conductive/sensorineural hearing loss, soft tissue stenoses, and no skin grafting required.

Conclusions: This is the first study to report a series of patients performing solely a transcanal approach using micro-osteotomes for removing exostoses. Results indicate that it is a safe procedure with low complication rate and expeditious healing. Patients with 100% obstruction can have this procedure performed with no significant increase in morbidity.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ear Canal / surgery
  • Ear Diseases / surgery*
  • Exostoses / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures / adverse effects
  • Otorhinolaryngologic Surgical Procedures / instrumentation*
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Retrospective Studies
  • Tympanic Membrane Perforation / epidemiology
  • Tympanic Membrane Perforation / etiology