Transcanal Excision of Exostoses: Large Series Comparing Bone Removal Methods

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).
• 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.