title: Outcomes of Drill Canalplasty in Exostoses and Osteoma: Analysis of 256 Cases and Literature Review.
abstract: 1) To describe the surgical technique of drill canaplasty for exostosis and osteoma and to evaluate our results. 2) To propose a new grading system for external auditory canal stenosis (EACS). 3) To review the recent literature.
  
  
  
  A retrospective review.
  
  
  
  Quarternary referral center for Otology & Skull Base surgery.
  
  
  
  Two hundred seventeen patients (256 ears) with exostosis or osteoma were included in the study. Surgical and audiological parameters were evaluated.
  
  
  
  Mean age was 51.5 (±13.41) years. One hundred sixty nine cases were men and 48 women. Two hundred forty three (95%) cases were exostosis and 13 (5%) were osteomas. According to the proposed grading system, 81% ears had severe or complete stenosis. Seventy eight (30.5%) ears had a concurrent diagnosis of otosclerosis. Retroauricular approach was used in 245 (95.7%). Intraoperative complications included tympanic membrane (TM) perforation seen in four (2%) and mastoid cell exposure in two (1%). Postoperative stenosis/prolonged healing was seen in 11 (4%) patients and required revision in seven cases. Audiologic analysis available for 153 ears-showed the mean change in air-bone gaps (ABG) of 2.18 dB, pure tone averages (PTA) bone conduction (BC) (0.5-4 kHz) of 0.3 dB. Mean healing rate was available for 246 (96.1%) patients and was found to be 6.35 (4-16) weeks.
  
  
  
  A systematically performed drill canalplasty via retroauricular approach, as described in this article, yields excellent postoperative outcomes as seen in our series. Notably, one-third of exostoses patients in this series, also suffered from otosclerosis. The proposed grading system for EACS enables the surgeon to objectively stage the disease.
authors.affiliation: *Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy†Department of Otorhinolaryngology, Hillel Yaffe Medical Center, Hadera, Israel‡Department of Otorhinolaryngology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Golda
authors.initials: G
authors.lastname: Grinblat
authors.forename: Sampath Chandra
authors.initials: SC
authors.lastname: Prasad
authors.forename: Gianluca
authors.initials: G
authors.lastname: Piras
authors.forename: Jingchun
authors.initials: J
authors.lastname: He
authors.forename: Abdelkader
authors.initials: A
authors.lastname: Taibah
authors.forename: Alessandra
authors.initials: A
authors.lastname: Russo
authors.forename: Mario
authors.initials: M
authors.lastname: Sanna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000601:surgery*; D005096:Exostoses / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D010016:Osteoma / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D010040:Otosclerosis / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D018058:Tympanic Membrane Perforation / Q000209:etiology; D055815:Young Adult