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Transcanal Excision of Exostoses: Large Series Comparing Bone Removal Methods.

Jack Shohet1,2, Drew Justeson3, Allison Wilkins1

  • 1Shohet Ear Associates Medical Group Inc, Orange County, California, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|March 23, 2023
PubMed
Summary

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Osteotome alone (OA) surgery for external auditory exostosis (EAE) showed the lowest complication rates post-surgery. This suggests OA offers a lower risk for patients undergoing transcanal EAE excision.

Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Auditory Health

Background:

  • External auditory exostosis (EAE) involves temporal bone growth into the ear canal, often due to cold water exposure.
  • Current EAE excision tools have varied complication rates, with limited comparative data.
  • Novel tools like piezoelectric devices require safety and efficacy evaluation.

Purpose of the Study:

  • To compare the intraoperative and postoperative complication rates of different surgical techniques for EAE excision.
  • To evaluate the safety and efficacy of osteotome alone (OA), osteotome with drill (OD), and osteotome with piezoelectric device (OP) for EAE treatment.

Main Methods:

  • Retrospective chart review of 413 subjects (472 ears) undergoing EAE excision.
  • Surgical groups included osteotome alone (OA), osteotome with drill (OD), and osteotome with piezoelectric device (OP).
Keywords:
cutting drillexostosisosteotomepiezoelectrictranscanal approach

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  • Analysis focused on intraoperative complications and postoperative symptoms and complications.

    • Main Results:

    • No significant differences in tympanic membrane perforations or total intraoperative complications across OA, OD, and OP groups.
    • OA group exhibited the lowest or near-lowest incidence of analyzed postoperative symptoms.
    • The osteotome alone group showed a significantly lower incidence of tinnitus compared to OD and OP groups.

    Conclusions:

    • Osteotome alone (OA) demonstrated the best performance in mitigating postoperative complications, although not always statistically significant.
    • OA appears to provide a lower intraoperative and postoperative risk for patients undergoing transcanal exostosis excision.
    • Further research may clarify the statistical significance of OA's benefits in EAE treatment.