title: Endoscopic transcanal removal of symptomatic external auditory canal exostoses.
abstract: Exostoses are bony outgrowths of the external auditory canal (EAC) that can lead to cerumen entrapment, recurrent infections, and conductive hearing loss. When surgical removal is indicated, a drill or osteotome may be used via a post-auricular, endaural, or transcanal approach. Studies suggest that exostoses removed by transcanal osteotome result in decreased morbidity when compared to open, drilled approaches; however, inadvertent injury to the facial nerve or inner ear is a theoretical concern given the restrictive geometry of the EAC and challenges of visualizing the tip of the chisel through the microscope. The endoscope provides superior visualization of the external auditory canal and tympanic membrane compared to the microscope. We sought to demonstrate the efficacy and safety of endoscopic exostosis surgery with an osteotome. We find that the endoscope provides improved wide angled views without blind spots. There were no intraoperative complications. Endoscopic canaloplasty for exostoses may be readily applied.
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, MA; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA. Electronic address: elliott_kozin@meei.harvard.edu.
authors.forename: Elliott D
authors.initials: ED
authors.lastname: Kozin
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, MA; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.
authors.forename: Aaron K
authors.initials: AK
authors.lastname: Remenschneider
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, MA; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.
authors.forename: Parth V
authors.initials: PV
authors.lastname: Shah
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, MA; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.
authors.forename: Edward
authors.initials: E
authors.lastname: Reardon
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, MA; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lee
mesh_terms: D000369:Aged, 80 and over; D004424:Ear Canal / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005096:Exostoses / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D038781:Otoscopy / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012494:Sampling Studies; D016896:Treatment Outcome