Exostoses of the external auditory canal

Table 1 Different approaches and surgical techniques

Ref.	Year	Endaural (operations)	Postauricular (operations)	Transcanal (operations)	Drilling (operations)	Osteotomes, chisels1
Altuna Mariezkurrena et al[33]	2004		× (52)		×
DiBartolomeo et al[30]	1979			× (21)	× (21)
Bordure et al[37]	1994	×	×		× (64)
Frese et al[38]	1999	× (56)	× (3)		× (59)
Hempel et al[31]	2012	× (33)	× (2)		NA
Hetzler[19]	2007			× (221)	× (42)2	× (179)
Hurst et al[39]	2001	× (58)	× (6)		×
King et al[29]	2010		× (80)		× (71)3	× (4)
Oostvogel et al[40]	1992	×	×		×
Portmann et al[41]	1991		× (25)		× (25)
Sanna et al[32]	2004		× (65)		× (65)
Stougaard et al[35]	1999	× (7)	× (1)	× (16)	× (24)
Timofeev et al[27]	2004	NA	NA	NA	× (46)
Whitaker et al[18]	1998			× (27)		× (27)

¹Hetzler[19] used osteotomes whereas King et al[29] and Whitaker et al[18] employed chisels;

²Both osteotomes and drilling burrs were used in these 42 patients;

³Hand-held surgical drill and chisel were used in 61 patients whereas drill only was employed in 10 patients. NA: Not applicable.

Table 2 Complications of exostoses removal

Ref.	Year	No. of patients	No. of ears	No. of operations	TM tears or perforations1	Stenosis or scarring1	SNHL	Tinnitus	TMJ entry
Altuna Mariezkurrena et al[33]	2004	45	52	52
Di Bartolomeo et al[30]	1979	16	21						1 (4.7%)
Bordure et al[37]	1994	36	64		8 (12.5%)		3 (4.7%)	2 (3.1%)	2 (3.1%)
Fisher et al[42]	1994	102		127	11 (8.6%)	2 (1.5%)	1 (0.8%)		1 (0.8%)
Frese et al[38]	1999	48		59	3 (5%)	4 (6.8%)	4 (6.8%)	1 (1.7%)
Hempel et al[31]	2012	30	35			1 (2.8%)	2 (5.7%)	1 (2.8%)
Hetzler[19]	2007	140	221	221	12		3 (1.3%)	3 (1.3%)	3 (1.3%)
Hurst et al[39]	2001	49		64	1 (1.5%)	23		1 (1.5%)	2 (1.9%)
King et al[29]	2010	58	83	83		4 (4.8%)		7 (8.4%)
Oostvogel et al[40]	1992	51			1 (2%)		3 (5.9%)
Portmann et al[41]	1991		25		1 (4%)		2 (8%)		1 (4%)
Reber et al[43]	2000	20		22	2 (9%)	2 (9%)	4 (18.2%)		2 (9.1%)
Sanna et al[32]	2004	57	65	65		2 (3%)	1 (1.5%)
Seehy et al[44]	1982			79	8 (10.1%)
Stougaard et al[35]	1999	19	24	24	1 (4.1%)		1 (4.1%)		1 (4.1%)
Timofeev et al[27]	2004	31	46	46		4 (8.7%)	1 (2.2%)	1 (2.2%)
Vasama et al[45]	2003	136	182	182	5 (2.7%)	2 (1.1%)	4 (2.2%)
Whitaker et al[18]	1998	18	27						7 (25.9%)

¹TM tears or perforations requiring underlay tympanoplasty, or stenosis or scarring requiring revision surgery;

²Although only one case required tympanoplasty, there were 29 tympanic membrane pinpoint tears that required no additional treatment and were healed by the time the ear canal skin had healed;

³One tympanic membrane perforation and 2 ears requiring revision surgery for removal of granulations and sequestered bone. SNHL: Sensorineural hearing loss; TM: Tympanic membrane; TMJ: Temporomandibular joint.