External auditory exostoses: Evaluation and treatment

Abstract

To determine (1) if external auditory exostosis (EAE) severity in a surgical exostosis population differs between ears and (2) the incidence of complications from postauricular canalplasty for EAE. A retrospective review. Three hundred twenty-seven patients (401 ears) underwent drill canalplasty for EAE from 1990 to 2006. EAE severity was graded, and air and bone thresholds were used to evaluate hearing changes. There were no significant differences in surgery rate or severity between right and left ears (71% grade 3 in both ears), with 95 percent grade 3 in operated ears. Prolonged healing occurred in 4.5 percent, with 1 TM perforation (0.2%). Sensorineural hearing at 4 kHz worsened slightly (mean change = 3.7 dB, P < or = 0.001), with 4.8 percent worsening >15 dB (maximum 30 dB), but sensorineural bone average was unchanged (mean = 0.2 dB). EAE recurred in 8 of 91 ears with long-term follow-up, occurring up to 15 years postsurgery. EAE severity in surgical patients does not differ between right and left ears. Drill canalplasty via the postauricular approach minimizes complications.