SURGERY FOR EXTERNAL AUDITORY-CANAL EXOSTOSES AND OSTEOMATA

The popularity of water sports in Western Australia results in a high demand for surgery for meatal exostoses when compared to Europe or Nor th America, and such procedures for advanced exostoses present a techn ical challenge. We report on a decade of experience in exostosis and o steoma surgery consisting of 127 procedures on 102 patients. Exostecto my was an access manoeuvre for other otological procedures in 13 cases and five procedures were for regrowth of exostoses. Minor complicatio ns were seen after 22 per cent of operations. Major complications were experienced after five per cent for example canal stenosis, temporoma ndibular joint prolapse, sensorineural loss, persistent deep bony lip and persistent tympanic membrane perforation. There were no facial pal sies. Exostosis surgery should be reserved for failed conservative tre atment and attention focused on adequate access, meatal skin preservat ion and tympanic membrane protection. An approach which concentrates o n safe anterior landmarks and wide exposure is recommended to avoid se rious complications.