Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-19T05:49:11.987Z Has data issue: false hasContentIssue false

Surgery for external auditory canal exostoses and osteomata

Published online by Cambridge University Press:  29 June 2007

Edward W. Fisher*
Affiliation:
Department of Otolaryngology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Nedlands, Western Australia 6009.
Terence C. McManus
Affiliation:
Department of Otolaryngology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Nedlands, Western Australia 6009.
*
E. W. Fisher, F.R.C.S., Senior Registrar, ENT Department Clinic 10, Addenbrooke's Hospital, Cambridge CB2 2QQ.

Abstract

The popularity of water sports in Western Australia results in a high demand for surgery for meatal exostoses when compared to Europe or North America, and such procedures for advanced exostoses present a technical challenge.

We report on a decade of experience in exostosis and osteoma surgery consisting of 127 procedures on 102 patients. Exostectomy was an access manoeuvre for other otological procedures in 13 cases and five procedures were for regrowth of exostoses. Minor complications were seen after 22 per cent of operations. Major complications were experienced after five per cent for example canal stenosis, temporomandibular joint prolapse, sensorineural loss, persistent deep bony lip and persistent tympanic membrane perforation. There were no facial palsies.

Exostosis surgery should be reserved for failed conservative treatment and attention focused on adequate access, meatal skin preservation and tympanic membrane protection. An approach which concentrates on safe anterior landmarks and wide exposure is recommended to avoid serious complications.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Burton, F. A. (1923) Aural exostosis. Annals of Otology, Rhinology and Laryngology 32: 97117.CrossRefGoogle Scholar
Clark, T. E. (1923) Electrolysis of exostosis of the ear. British Medical Journal 2: 656657.Google Scholar
Di Bartolomeo, J. R. (1979) Exostoses of the external auditory canal. Annals of Otology, Rhinology and Laryngology 88 (Suppl. 61): 120.Google ScholarPubMed
Fagan, P. A. (1990) The surgical removal of aural exostoses. Journal of the Otolaryngological Society of Australia 6: 220221.Google Scholar
Fowler, E. P., Osmun, P. M. (1942) New bone growth due to cold water in the ears. Archives of Otolaryngology 36: 455466.CrossRefGoogle Scholar
Friedmann, I. (1974). Pathology of the Ear, Blackwell, Oxford, pp 152156.Google Scholar
Gerlings, P. G. (1979). Atlas of the Histopathology of Ear Tumours, Lloyd-Luke, London, pp 2133.Google Scholar
Gill, N. W. (1987) Surgical treatment of meatal exostoses. In Rob and Smiths Operative Surgery. 4th Edition. The Ear. (Ballantyne, J. C., Morrison, A., eds.), Butterworth-Heinemann, Oxford, pp 1315.Google Scholar
Glasscock, M. E., Shambaugh, G. E. (1990). Surgery of the Ear, 4th Edition, W. B. Saunders, Philadelphia, pp 203205.Google Scholar
Goodhill, V. (1979). Ear Diseases, Deafness and Dizziness, Harper and Row, Hagerstown, pp 466471.Google Scholar
Graham, M. D. (1979) Osteomas and exostoses of the external auditory canal. Annals of Otology, Rhinology and Laryngology 88: 566572.CrossRefGoogle ScholarPubMed
Harrison, D. F. N. (1962) The relationship of osteomata of the external auditory meatus to swimming. Annals of the Royal College of Surgeons of England 31: 187201.Google ScholarPubMed
Hubby, L. M. (1947) Exostosis of the external auditory canal. In Surgery of the Ear. (Kopetzky, S. J., ed.), Thomas Nelson and Sons, New York, pp 155157.Google Scholar
Jung, T. K. (1989) External ear canal procedures. In Atlas of Otologic Surgery. (Goycoolea, M. V., ed.), W. B. Saunders, Philadelphia, pp 149158.Google Scholar
Kemink, J. L., Graham, M. D. (1982) Osteomas and exostoses of the external auditory canal - medical and surgical management. Journal of Otolaryngology 11: 101106.Google ScholarPubMed
Kopetzky, S. J. (1925). Otologic Surgery, Hoeber, New York, pp 4851.Google Scholar
Litton, W. B., Krause, C. J., Anson, B. A., Cohen, W. N. (1969) The relationship of the facial canal to the annular sulcus. Laryngoscope 79: 15841604.CrossRefGoogle Scholar
Mawson, S. R. (1967). Diseases of the Ear, 2nd Edition, Arnold, London, pp 255257.Google Scholar
Michaels, L. (1987). Ear, Nose and Throat Histopathology, Springer-Verlag, London, p 63.CrossRefGoogle Scholar
Naumann, H. H. (1982). Head and Neck Surgery, (Naumann, H. H., ed.), vol. 3, Ear, W. B. Saunders, Philadelphia, pp 7984.Google Scholar
Rhys-Evans, P. (1992) The paranasal sinuses and other enigmas: an aquatic evolutionary theory. Journal of Laryngology and Otology 106: 214225.CrossRefGoogle ScholarPubMed
Roche, A. F. (1964) Aural exostoses in australian aboriginal skulls. Annals of Otology, Rhinology and Laryngology 73: 8291.CrossRefGoogle ScholarPubMed
Schukneckt, H. F. (1974). Pathology of the Ear, Harvard University Press, Cambridge, p 385.Google Scholar
Schuknecht, H. E., Gulya, A. J. (1986). Anatomy of the Temporal Bone with Surgical Implications, Lea and Febiger, Philadelphia, pp 43–4.Google Scholar
Scrivener, B. P. (1982) Exostoses: how to get them right. Journal of the Otolaryngological Society of Australia 5: 6770.Google Scholar
Seftel, D. M. (1977) Ear canal hyperostosis: surfer's ear. Archives of Otolaryngology 103: 5860.CrossRefGoogle ScholarPubMed
Sheehy, J. L. (1958) Osteoma of the external auditory canal. Laryngoscope 68: 16671673.CrossRefGoogle ScholarPubMed
Sheehy, J. L. (1982) Diffuse exostoses and osteomata of the external auditory canal: a report of 100 operations. Otolaryngology - Head and Neck Surgery 90: 337342.Google ScholarPubMed
Tod, H. (1910) Exostosis of the right external meatus in a boy age 10. Proceedings of the Royal Society of Medicine (Otological section) 3: 7678.Google Scholar
Van Gilse, P. H. G. (1938) Des observations ulterieures sur la genese des exostoses du conduit externe par l'irritation d'eau froide. Acta Otolaryngologica 26: 343352.CrossRefGoogle Scholar
Williams, B. J. (1988) The relationship of the facial nerve to the tympanic annulus and external auditory canal. Journal of the Otolaryngological Society of Australia 6: 9596.Google Scholar