Osteotome technique for removal of symptomatic ear canal exostoses.
OBJECTIVE
This study was undertaken to assess a transcanal osteotome technique for removing symptomatic ear canal exostoses. Outcome measures included healing rates and the rate of complications.


METHODS
Prospective study in a private practice.


METHODS
A straight 1-mm osteotome and a curved 1-mm osteotome were used by way of a transcanal approach to incrementally remove obstructive ear canal exostoses. If anterior or superior bone growths were closely approximating the tympanic membrane, they were partially removed with a 1.5 mm cylindrical end- and side-cutting burr. Healing rates were monitored with weekly postoperative visits.


RESULTS
Two hundred twenty-one ear canals (140 patients) were consecutively treated with this technique. Healing was achieved at 2 to 8 (average 3.50) weeks, with 90% healed by 4 weeks. There were 4 mobilizations of a full-thickness segment of anterior bony canal wall; 3 exposures of periosteum anterior to the anterior bony wall; 1 tear of the tympanic membrane requiring a tympanoplasty; 18 anterior and 11 posterior tympanic membrane tears that healed spontaneously; 3 instances of sensorineural hearing decrease; 3 cases of new-onset postoperative tinnitus; and 1 instance of postoperative positioning vertigo. There were no lacerations of the tympanic membrane by an osteotome, no facial nerve injuries, no soft tissue stenoses of an ear canal, and no skin grafting of an ear canal.


CONCLUSIONS
The described technique of using osteotomes transcanal for removal of symptomatic obstructive ear canal exostoses promoted rapid healing and was effective and safe.
Hetzler
Douglas G
DG
Department of Otolaryngology-Head and Neck Surgery, Santa Cruz Medical Clinic, Inc., an affiliate of the Palo Alto Medical Foundation, Santa Cruz, California, USA. hetzled@sutterhealth.org
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004424:Ear Canal / Q000601:surgery*; D004427:Ear Diseases / Q000601:surgery*; D005096:Exostoses / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing