Transcanal Micro‐osteotome Technique for Excision of Exostoses

Abstract

Objectives: This study was conducted to evaluate the outcomes and complications of transcanal excision of exostoses using micro-osteotomes without a post-auricular incision or the use of the drill. Methods: A retrospective chart review of patients undergoing exostoses excision by the senior author from January 2007 to January 2014 was carried out. All patients underwent surgical removal of the exostoses using a 1 or 2 mm micro-osteotome. Patients were followed postoperatively and complications were evaluated. Results: One-hundred-thirty-eight ears in 106 patients were treated for exostosis. Average age of patients was 43 ± 16 year old. Of these, 99 were males (93%) and 7 were females (7%). A majority of the patients had 90% to 100% obstruction of the ear canal. Complete ear canal healing was seen in 80% of patients by 3 weeks. All but one patient had healed by 6 weeks postoperatively. There were 9 (6.5%) slit tympanic membrane perforations that all healed. One patient had an anterior canal mobilization which required Xeroform packing for 3 weeks for stabilization. There was no postoperative vertigo, facial paresis, conductive/sensorineural hearing loss, soft tissue stenoses, and no skin grafting was required. Conclusions: A transcanal approach using micro-osteotomes for removing exostoses is feasible. The transcanal approach afforded shorter healing times than the post-auricular approach as reported in the literature. Patients with 100% obstruction can have this procedure performed with no significant increase in morbidity.